胃癌患者治疗前后血清可溶性肿瘤坏死因子受体Ⅰ的变化及其意义

CLINICAL SIGNIFICANCE OF SERUM LEVELS OF SOLUBLE TUMOR NECROSIS FACTOR RECEPTOR-Ⅰ IN PATENTS WITH GASTRIC CANCER

目的探讨胃癌患者治疗前后血清可溶性坏死因于受体（ｓＴＮＦ－Ⅰ）水平的临床意义。方法应用酶联免疫吸附测定（ＥＬＩＳＡ）的方法测定了３４例胃癌患者ｓＴＮＦＲ－Ⅰ水平。结果胃癌患者血清ｓＴＮＦＲ－Ⅰ水平明显高于正常人（Ｐ＜０．０１），且与临床分期有关，病情越晚，ｓＴＮＦＲ－Ⅰ水平越高，ｓＴＮＦＲ－Ⅰ水平超过３．００ｎｇ／ｍｌ者预后不良；治疗有效者ｓＴＮＦＲ－Ⅰ均显著下降（Ｐ＜０．０１），２４例治疗后４～８个月再次采血检验，８例无瘤生存者ｓＴＮＦＲ－Ⅰ水平降至正常，其余１６例肿瘤未控制或复发转移者血清ｓＴＮＦＲ－Ⅰ水平升高。结论血清ｓＴＮＦＲ－Ⅰ测定对胃癌疗效观察、病情监测及预后判断有重要意义。

PURPOSE To asses the clinical significance of serum levels of soluble tumor necrosis factor receptorI (sTNFR-I) in gastric cancer patients before and after therapy.METHODS The levels of sTNFR-I in 34 patients with gastric cancer were measured by ELISA before and after surgery or chemotherapy.RESULTS The results were as follows:serum sTNFR-I levels in the gastric cancer patients were significantly higher than those in healthy controls (P<0.01). Correlated to clinical staging, they increased greatly in advanced disease. The frequency of increase in sTNFR-I(82.4%) greatly exceeded that carcinoembryonic antigen (20.6%). sTNFR-I levels in patients were decreased after effective therapy. A value above 3.00ng/ml had a poor prognosis. Among them, 24 patients were tested again during period of 4 to 8 months after therapy,sTNFR-I levels declined to normal in 8 and elevated in the other 16,where the cancerous growth was not controlled or recurred locally or there occurred metastasis.CONCLUSIONS This study suggests that measurment of serum sTNFR-I patients with gastric cancer is of diagnostic and prognostic importance as well as in evaluating the efficacy of treatment.