胃癌患者血清和组织中sIL-2R与sICAM-1水平的变化及意义

目的 :研究胃癌患者血清及组织中sIL 2R和sICAM 1变化的临床意义。方法 :采用双抗体夹心ELISA法 ,对 5 8例胃癌患者手术前后、32例胃良性疾病患者及 36例健康体检者血清sIL 2R和sICAM 1水平进行检测 ;并检测胃癌及胃良性疾病者活检组织中该两项指标的浓度。结果 :胃癌患者血清sIL 2R(U/L)和sICAM 1(mg/L)为911± 179,9.193± 4.198,分别明显高于胃良性疾病者 30 3± 2 0 ,0 .6 14± 0 .0 6 1和健康体检者 30 1± 15 ,0 .5 77± 0 .145(P均 <0 .0 0 1)。胃癌组织中sIL 2R和sICAM 1为 934± 197,9.76 4± 3.744明显高于胃良性疾病胃粘膜组织 311±2 0 ,0 .6 2 4± 0 .0 6 3(P均 <0 .0 0 1)。胃癌从Ⅰ～Ⅳ期上述两种成分在血清和组织中均逐渐增高 ,且各期之间进行比较P <0 .0 0 1;其中Ⅰ～Ⅲ期术后血清两种成分均明显下降P <0 .0 0 1;而Ⅳ期手术前后无明显变化 ;手术切除组术后两种成分亦明显降低 ,P <0 .0 0 1,而探查者或胃空肠吻合术者 ,术后两种成分反而增高。结论 :动态观察血清及组织sIL 2R和sICAM 1的变化可作为胃癌的诊断、手术方法的选择、疗效评价及预后监测有意义的参考指标。

The Changes and Significance of Levels of sIL-2R and sICAM-1 in Serum and Tissue of Patients with Gastric Cancer

To study the changes and the clinical significance of serum and tissue soluble interleukin-2 receptor(sIL-2R) and soluble intercellular adhesion molecule-1(sICAM-1) in patients with gastric cancer.Methods:Serum levels of sIL-2R and sICAM-1 were detected by the double antibody sandwich ELISA method in 58 gastric cancer patients before and after operation,32 benign disorders(26 superficial antral gastritis and 6 non-ulcer dyspepsia) and 36 controls.Simultaneously,tissue levels of sIL-2R and sICAM-1 were measured in the gastric cancer patients and benign disorders.Results:(1)The serum sIL-2R(911±179)U/L vs (303±20)U/L,(301±15)U/L(P＜0.001) and sICAM-1(9.193±4.198)mg/L vs (0.614±0.061)mg/L,(0.577±0.145)mg/L(P＜0.001) in gastric cancer patients were significantly higher than those of the benign disorders and healthy controls;(2)The tissue sIL-2R(934±197)U/L vs (311±20)u/L(P＜0.001) and sICAM-1(9.794±3.744)mg/L vs (0.624±0.063)mg/L(P＜0.001) in the gastric cancer patients were significantly higher than those of the benign disorders;(3)The serum and tissue levels of sIL-2R and sICAM-1 showed statistical difference among the gastric cancer patients of Ⅰ、Ⅱ、Ⅲ、Ⅳ stage(one another comparison P＜0.001)；(4)Both declined remarkably after gastrectomy in the Ⅰ、Ⅱ、Ⅲ stage of the gastric cancer(P＜0.001).Nevertheless,Ⅳ stage of the gastric cancer was not changed before and after operaiton;(5)The serum levels of sIL-2R and sICAM-1 declined remarkably after operaiton.Conversely,both increased after exploratory laparotomy and gastroenterostomy.Conclusion:Dynamic alterations of serum and tissue sIL-2R and sICAM-1 levels can be used as indicators of early diagnosis, seleotion of the operative method and prognosis in patients with gastric cancer.