血清层粘连蛋白在大肠癌中的检测及临床应用

Clinical application of measuring the serum laminin in patients with colorectal cancer

目的 探讨检测血清层粘连蛋白 (LN)含量对大肠癌的诊断价值及术前术后含量的变化 ,了解其对大肠癌预后的判断、监测肿瘤有无复发和转移的意义 ,并通过与血清癌胚抗原 (CEA)、糖类抗原 2 4 2 (CA2 4 2 )比较 ,评价血清LN对大肠癌的临床意义。方法 应用放射免疫技术测定大肠癌患者血清LN、CEA、CA2 4 2 含量。结果 血清LN检测对 4 4例大肠癌诊断的特异性为 84 .1% ,敏感性为92 .7% ,各Dukes分期大肠癌患者血清LN含量均高于良性病变组和对照组 (P <0 .0 5 ) ,且良性病变组与对照组之间血清LN含量差异无显著性 (P >0 .0 5 ) ;DukesC、D期组血清LN含量高于DukesA、B期组 (P <0 .0 5 ) ;血清LN含量术后较术前降低 (P <0 .0 5 )。大肠癌患者术前血清LN阳性率高于CEA和CA2 4 2 (P <0 .0 5 )。结论 大肠癌患者血清LN含量的检测对诊断、判断预后、指导临床治疗和与良性病变鉴别有一定参考价值。

Objective To investigate the changes of serum contents of laminin (LN) in preoperative and postoperative patients with colorectal cancer and its value in diagnosis and prognosis of the cancer,and to evaluate the clinical significance of serum LN in neoplastic relapse and metastasis as compared with CEA and CA 242. Method The contents of LN, CEA and CA 242 in serum were measured by radioimmunoassay in patients with colorectal cancer.Results In 44 colorectal cancer patients,the specificity,sensitivity and accuracy of serum LN in diagnosis of the cancer were 84.1%,92.7% and 89.3% respectively.The contents of serum LN in all cancer groups of different Dukes stages were significantly higher than those in control group and benign disease group (P<0.05). There was no difference between control group and benign disease group (P>0.05). The contents of LN in Dukes C and D were higher than those in Dukes A and B(P<0.05).The content of LN in postoperative group was lower than that in preoperative group (P<0.05).In all patients with colorectal cancer, the positive rate of LN was higher than those of CEA and CA 242(P<0.05).Conclusion Serum LN is helpful to diagnosis, judgment of prognosis and instructing clinical therapy of colorectal cancer.