消化道良、恶性疾病的12种微量元素的测定与临床意义

Determination of 12 Trace Elements in Serum of Patients with Benisn and Malignant Lesion of Alimentary Tract

本文测定174例胃肠道疾病,40例原发性肝癌及85例正常人血清Cu、Zn、Ca、Mg、Fe、Sr、Mn、Mo、Cr、Ti、Ni、Se等12种微量元素。结果表明:血清铜升高、锌降低,Cu/Zn比值升高最明显为原发性肝癌,其次为胃肠癌,再次为胃肠息肉,最后为慢性腹泻。慢性腹泻与正常比仅锌下降,钙与锌在各组改变与锌相似。胃肠癌转移组与正常组比,术前组、术后组与正常组之间其Cu/Zn比值升高,且均有统计学意义(P<0.05)。胃肠癌组与息肉组比较,血清钙显著降低(P<0.001),铁无差异;而胃肠癌组与慢性腹泻组比,血清铁降低显著而钙无差异。胃肠癌中65例腺癌病理分化与微量元素无明显关系。由此表明微量元素改变对鉴别消化道良、恶性疾病和临床观察有一定帮助。

Contents of 12 serum trace elements (Cu, Zn, Ca, Mg, Fe, Sr, Mo, Mn, Cr, Ti, Ni, Se) in 174 patients with gastrointestinal disease were assayed and compared with those from 40 primary hepatocellular carcinoma (PHC)patients and 85 healthy individuals. The results showed that increase of serum copper (SCu) and decrease of serum zinc (SZn) made the copper to zinc (Cu/Zn) ratio elevated. These phenomena were remarkable in PHC and less significant in gastrointestinal cancer, polyp and chronic diarrhea. The situation with calcium was similar to zinc. In metastatic G-I tract cancer patients or cancer patients prior to surgery Cu/Zn ratio was significantly higher than in normal donors (P<0.05). The level of S Ca in cases of gastrointestinal cancer was notably lower as compared with patient with polyp (P<0.001) while it was the other way round with serum iron. There was no significant difference between trace elements in 65 patients with adenocarcinoma in terms of histological differentiation. These results suggested that alteration of levels of trace elements might be a helpful clue in differentiating benign disease and carcinoma during clinical followup observation.