肿瘤患者血清血管性血友病因子裂解酶与可溶性尿激酶受体和胸腺素α1的检测及意义

Alteration of the serum von Willebrand factor-cleaving protease activity, soluble urokinase receptor and thymosin alpha 1 levels in tumor patients

目的 探讨和比较不同病理状态下实体肿瘤患者血清血管性血友病因子裂解酶(vWF-cp)活性及可溶性尿激酶受体(suPAR)水平和胸腺肽α1(Tα1)水平的改变的意义。方法 以残余胶原结合力(R-CBA)检测血清vWF-cp活性水平、免疫放射分析测定suPAR水平及酶联免疫吸附试验检测Tα1水平。比较不同病理状态下84例恶性肿瘤患者血清vWF-cp活性水平,以及vWF-cp活性水平与suPAR和Tα1水平预示恶性肿瘤存在的敏感性和特异性。结果 (1)vWF-cp活性水平在恶性肿瘤患者中显著降低,而suPAR和Tα1水平则显著增高。伴有远处转移的恶性肿瘤患者vWF-cp活性更低,下降至55.8％±16.2％(P<0.05)。而suPAR水平则在局部淋巴结浸润和远处转移的患者中均增高(P<0.05和0.01)。(2)在恶性肿瘤患者中,Tα1与suPAR水平是较敏感的指标,而vWF-cp则是一个较特异的指标。vWF-cp活性水平与suPAR水平存在较好的相关性(r=0.39,P<0.001),但和Tα1无相关性。结论 vWF-cp活性、suPAR水平和Tα1水平在恶性肿瘤患者血清中显著改变,但三者变化的程度不同。联合检测三者的水平有助于判断肿瘤的良恶性以及了解患者的病情发展。

Objective To compare the clinical significance of von Willebrand factor-cleaving protease (vWF-cp) activity, soluble urokinase receptor (suPAR) and thymosin alpha 1 (Tα1) levels in tumor patients. Methods The serum vWF-cp activity, suPAR and Tα1 levels in health controls, patients suffering from benign and malignant tumors were measured by residual collagen binding activity (R-CBA) , immunoradiometric assay and enzyme-linked immunoadsorbent assay, respectively. The association of their levels with pathological status was compared. The sensitivity and specificity in predicting cancer were also evaluated. Results (1) The alteration of vWF-cp activity in malignant tumor patients was significant as that of suPAR and Tα1. The vWF-cp activity was decreased ( P < 0. 05 ) , and suPAR level was increased in patients with both local lymph node involvement and distal metastasis. (2) In preoperation patients, the alteration of vWF-cp was more specific, while that of Tal and suPAR were more sensitive. In all of the cancer patients, the vWF-cp activity correlated with the suPAR level (r =0. 39, P < 0. 001) ; however, there was no relationship between the vWF-cp activity and Tal level. Conclusion The alterations of the vWF-cp activity, suPAR and Tal levels in malignant patients might be predictive for clinical status. Therefore, measurement of the three molecules in cancer patients would contribute to understand the patients' conditions.