食管癌患者血清可溶性肿瘤坏死因子受体水平测定

Determination of Serum Levels of Soluble Tumor Necrosis Factor Receptors in Patients with Esophageal Cancer

背景:目前尚无敏感性和特异性较高的血清肿瘤标志物用于临床诊断食管癌。目的:通过测定食管癌患者血清可溶性肿瘤坏死因子受体(sTNFR)水平的变化,探讨其在食管癌诊断和监控中的临床意义。方法:应用双抗体夹心酶联免疫吸附测定(ABC鄄ELISA)检测56例食管癌患者和10名健康成人的血清sTNFR鄄Ⅰ、sTNFR鄄Ⅱ水平,并与血清癌胚抗原(CEA)水平进行比较。结果:食管癌患者的血清sTNFR鄄Ⅰ和CEA水平显著高于健康对照组(P<0.001),而sTNFR鄄Ⅱ水平则显著低于健康对照组(P<0.001);sTNFR鄄Ⅰ与CEA的阳性率无显著差异,但均显著低于sTNFR鄄Ⅱ(P<0.001)。食管癌切除术后,患者的血清sTNFR鄄Ⅰ、sTNFR鄄Ⅱ水平均呈升高趋势,而CEA水平则无明显变化。结论:同时检测血清sTNFR鄄Ⅰ、sTNFR鄄Ⅱ水平有助于诊断食管癌和评估机体的免疫状态。

Background: At present, the serum tumor markers for clinical diagnosis of esophageal cancer with high sensitivity and specificity have not been available. Aims: To determine the changes of serum soluble tumor necrosis factor receptors (sTNFR) levels in patients with esophageal cancer, in order to explore their clinical significance in the diagnosis and surveillance of esophageal cancer. Methods: The serum levels of sTNFR-Ⅰ and sTNFR-Ⅱ were measured by avidin-biotin complex enzyme-linked immunosorbent assay (ABC-ELISA) in 56 patients with esophageal cancer and 10 healthy adults, and compared with the serum level of carcinoembryonic antigen (CEA). Results: The serum levels of sTNFR-Ⅰ and CEA in esophageal cancer patients were significantly higher than those in the healthy controls (P<0.001), and the serum level of sTNFR-Ⅱ was unusually lower (P<0.001); No significant differences in positivity rate were observed between sTNFR-Ⅰ and CEA, both of which were markedly lower than that of sTNFR-Ⅱ(P<0.001). The serum levels of both sTNFR-Ⅰ and sTNFR-Ⅱ increased after resection of esophageal cancer, but no obvious change was seen in the level of CEA. Conclusions: The simultaneous determination of serum levels of sTNFR-Ⅰ and sTNFR-Ⅱ is useful in the diagnosis of esophageal cancer and in the evaluation of patient's immune status.