肾癌患者血清中可溶性人类主要组织相容性复合体Ⅰ类链相关基因A蛋白的表达和临床意义

Expression and clinical implication of serum soluble major histocompatibility complex class Ⅰ related chain A protein in patients with renal carcinoma

目的探讨血清中可溶性人类主要组织相容性复合体Ⅰ类链相关基因A蛋白(sMICA)检测对肾癌患者的临床诊断价值。方法应用酶联免疫吸附试验测定40例肾癌患者(肾癌组)手术前后和40名健康者(对照组)的血清sMICA水平,并对血清sMICA水平与临床特征的关系进行分析。结果肾癌组术前的血清sMICA水平为(366.15±27.89)pg/mL,显著高于对照组的(214.03±22.15)pg/mL(P<0.01)。肾癌组术后的血清sMICA水平为(229.18±45.54)pg/mL,显著低于术前水平(P<0.01),与对照组的差异无统计学意义(P>0.05)。肿瘤TNM分期中Ⅲ期和Ⅳ期肾癌患者的血清sMICA水平为(443.79±27.21)pg/mL,显著高于Ⅰ期和Ⅱ期患者的(310.68±40.93)pg/mL(P<0.05),而男性与女性患者间、<65岁与≥65岁患者间血清sMlCA水平的差异均无统计学意义(P值均>0.05)。结论血清sMICA水平可作为肾癌的一个辅助诊断指标,且其与肾癌患者的免疫功能状态和临床分期有一定的关系。

Objective To evaluate the role of serum soluble major histocompatibility complex classⅠ related chain A（sMICA）protein in the diagnosis of renal carcinoma.Methods Serum sMICA was determined by enzyme-linked immunosorbent assay（ELISA）in 40patients with renal carcinoma before and after surgery and 40 healthy controls.The correlation between sMICA and clinical features was analyzed.Results The level of sMICA in patients with renal carcinoma before surgery was significantly higher than that in controls（[366.15± 27.89]pg/mL vs.[214.03±22.15]pg/mL,P0.01）.The level of postoperative sMICA was（229.18± 45.54）pg/mL,which was significantly lower than the preoperative level（P0.01）,while it was not statistically different with that in healthy controls（P0.05）.The level of sMICA in patients with TNM stage Ⅲ and Ⅳwas significantly higher than that at stage Ⅰ andⅡ（[443.79±27.21]pg/mL vs.[310.68±40.93]pg/mL,P 0.05）.There was no significant difference in sMICA between men and women or between the patients aged 65years and ≥65years（both P0.05）.Conclusion sMICA can serve as an assisstant indicator for the diagnosis of renal carcinoma and has a correlation with patient immune function and clinical stage of renal carcinoma.