胆囊癌与胆结石病人血清、胆汁肿瘤坏死因子及其受体检测的临床意义

目的 探讨肿瘤坏死因子（TNF）、可溶性肿瘤坏死因子受体（sTNFR)在胆囊结石致胆囊癌变的机理。方法 采用放射免疫法和双抗体夹心酶联免疫法对53例胆囊结石和9例胆囊癌伴结石病人血清及胆法中TNF，sTNFR水平进行检测。结果 胆囊结石及胆囊癌病人血清TNF水平均高于正常对照组（P＜0.05)，且随着胆囊粘膜病变的加重而增高，在胆囊粘膜典型增生、不典型增生、胆囊癌3组中，TNF逐级升高，每两组间均有显著性差异（P＜0.05)，且随着胆囊粘膜病变的加重而增高，在胆囊粘膜典型增生、不典型增生、胆囊癌3组中，TNF逐级升高，每两组间均有显著性差异（P＜0.05)。结论 TNF，sTNFR参与了胆囊结石致癌的发病过程，且与胆囊癌的临床生物学特点密切相关。

Clinical significance of detecting tumor necrosis factor and its receptor in serum and bile in patients with gallbladder cancer and gallstone

Objective To investigate the roles of tumor necrosis factor (TNF) and soluble tumor necrosis factor receptor (sTNFR) in development of gallbladder cancer induced by gallstone. Methods The levels of TNF and sTNFR were measured by RIA and ELISA in 9 patients with gallbladder cancer and 53 patients with gallstone. Results The levels of TNF and sTNFR in the serum and bile in patients with gallstone and gallbladder cancer increased significantly as compared with the normal individuals (P<0 05). Meanwhile, they gradually increased in the course of the development of gallbladder mucosa lesions from hyperplasia, dysplasia to cancer. There was significant difference between any of the two (P<0 05). Conclusions TNF and sTNFR participate in the pathogenesis of gallbladder cancer induced by gallstone. The levels of TNF and sTNFR are closely correlated to the clinical biological characteristics of the tumor.