结直肠癌患者外周血前列腺素E2水平测定的临床意义

目的：探讨结直肠癌患者外周血前列腺素E2（PGE2）在手术前后的动态变化及临床意义.方法：61例结直肠癌患者按是否有转移分成2组,远处转移组15例,无远处转移组46例;行根治性切除41例（根治组）,姑息性切除11例（姑息组）,剖腹探查9例（剖腹组）.对照组为30名健康体检者.分别检测患者手术前后外周血和肿瘤组织、正常结直肠黏膜组织PGE2及健康体检者血的PGE2含量.结果：结直肠癌患者术前外周血PGE2水平明显升高,外周血PGE2水平在DukesJD期者显著高于Dukes A、B、C期者（P＜0.01）,结直肠癌患者无远处转移组外周血PGE2水平与肿瘤大小呈正相关关系（P＜0.01）,肿瘤组织的PGE2含量显著高于正常结直肠黏膜组织（P＜0.01）.手术切除原发肿瘤后外周血PGE2显著下降,其中根治组和对照组差异无统计学意义（P＞0.05）,姑息组和剖腹组术后PGE2水平仍显著高于对照组（P＜0.01）.结论：结直肠癌患者外周血PGE2升高是肿瘤源性的,外周血PGE2动态检测可视为判断结直肠癌根治术后有否复发或转移的辅助指标.

Clinical significance of peripheral blood PGE2 level in patients with colorectal carcinoma

Objective：To investigate the dynamic change of peripheral blood prostaglandin E2 （PGE2 ） level before and after operation and its clinical significance in patients with colorectal carcinoma. Methods：Sixty-one patients with colorectal carcinoma were divided into Non-distant metastasis group 46 cases and distant metastasis 15 cases, thirty healthy people formed the control group. Among 61 patients, forty-one, eleven and nine cases were treated with resection, palliative resection and laparotomy, respectively. The PGE2 levels of peripheral blood and tumor tissue before and after operation in patients and normal colorectal mucosa and peripheral blood in healthy people were detected. Results ： The PGE2 levels of peripheral blood before operation in patients with colorectal carcinoma were obviously increased, the PGE2 levels of patients with stage D were significantly higher than that in stage A, B and C （ P 〈 0.01 ）. The level of peripheral blood PGE2 in patients with Non-distant metastasis was positive correlation with tumor size（ P 〈 0.01 ）. The level of PGE2 in tumor tissue was significant higher than that in normal colorectal mucosa （P 〈 0.01 ）. The PGE2 levels of peripheral blood after were operation decreased significantly, the PGE2 level difference between the patients treated with resection and healthy people was not statistical significance （P 〉 0.05 ）. The PGE2 levels of patients treated with palliative resection and laparotomy were significantly higher that in control group（ P 〈 0.01 ）. Conclusions ：The high PGE2 level of peripheral blood in patients with colorectal carcinoma originated from the tumor. The dynamic detection of peripheral blood PGE2 may be considered as an auxiliary index in predicting the recurrence and metastasis of colorectal carcinoma after radical resection.