肺癌根治术后sICAM-1水平的变化及其意义

Clinical significance of the serum-soluble intercellular adhesion molecule-1 in patients undergoing radical resection of lung cancer

目的 了解可溶性细胞间粘附分子 1(solubleintercellularadhesionmolecule ,sICAM 1)在肺癌患者血清中的表达状况及手术前后sICAM 1水平的变化趋势 ,探讨检测血清sICAM 1在肺癌鉴别诊断、病情判断及转移中的作用。方法 本实验以肺癌手术切除标本、正常肺组织、肺癌及肺良性病变患者血清为研究对象 ,采用免疫组化、酶联免疫吸附试验方法进行了研究。结果 肺癌患者组血清sICAM 1水平明显高于肺良性病变组 (P <0 0 1) ;且Ⅲ Ⅳ期组高于Ⅰ Ⅱ期组(P <0 0 5 ) ;ICAM 1阳性表达组血清sICAM 1含量较ICAM 1阴性组高 ;转移组含量较无转移组高 (P <0 .0 5 ) ;与肺癌术前比 ,根治组术后 3d血清sICAM 1水平明显升高 (P <0 0 1) ,术后 7d出现下降趋势 ,术后 14d根治组血清sICAM 1水平明显低于术前水平 (P <0 0 1) ,而探查组与术前比无明显变化。结论 肺癌患者血清中sICAM 1水平增高提示肺癌晚期、有淋巴结转移、预后差 ;肺癌根治术后 14d血清sICAM 1水平明显低于术前水平 ,检测血清sICAM 1水平有助于判断病情及手术治疗效果。

To investigate the expressions and changes of serum soluble intercellular adhesion molecule-1 (sICAM-1) in lung cancer patients before and after operation and the roles of sICAM-1 in differential diagnosis, metastatic potential, and prognosis. Methods From 2002 to 2003, a total of 17 samples of lung carcinoma tissues and sera were studied. The other 11 non-cancer patients were employed as the controls. Cell surface sICAM-1 levels were analyzed by immunohistochemistry method and ELISA. Results The serum sICAM-1 concentration in the cancer patients was (432.0±124.4) ng/ml. In the controls, however, the serum concentration of sICAM-1 was (262.3±77.7) ng/ml. In patients with lung cancer, the serum concentration of sICAM-1 was significantly higher than that of the controls (P<0.01). In addition, the difference in the serum concentrations was significant between the patients with Ⅰ-Ⅱ and Ⅲ-Ⅳ stages (P<0.05). The serum concentration in group with positive ICAM-1 was higher than that in group with negative (P<0.05). Futhermore, compared with the peropertive level, the concentration of sICAM-1 in the radical operation group was significantly increased at 3 d after operation, but decreased at 7 d, and decreased significantly at 2 weeks (P<0.01). However, no significant difference was found in the explorative group before and after operation (P>0.05). Conclusion The serum sICAM-1 concentrations in lung cancer patients may play an important role in staging and may also serve as a useful indicator of advanced disease.