胃癌患者术前外周血CCL18的检测及其意义

Pre-operative detection of CCL18 in gastric cancer patients and its significance

背景与目的：趋化因子配体18（CCL18）主受由树突状细胞及单核细胞分泌，吸引淋巴细胞及未成熟的树突状细胞参与初次免疫应答文献报道多与自身免疫疾病相关，如戈谢病、特应性皮炎等，其在肿瘤中的表达及意义文献报道不多，与胃癌的关系则鲜有研究本研究通过检测各期胃癌患者术前外周血中CCL18含苗的变化，探讨其临床意义方法。收集本院腹部外科2005年7月-12月胃镜活检证实胃癌患者60例，无于术禁忌症。其中男性41例，女性19例，年龄30～76岁，中位年龄53．5岁。另取20份健康体检者外周血标本作为正常人群对照，以ELISA法检测血浆CCL18含量。结果：60例胃癌患者外周血中CCL18浓度为（115．94±22．56）μg/ml，显著高于健康人（42．46±13．97）pg／ml（P=0．000）胃癌术前外周血中CCL18的浓度随N分期、TNM分朗的升高及肿瘤分级（G）的降低而降低。TNM Ⅲ、Ⅳ期胃癌患者血浆中CCL18的浓度与健康人无差别。结论：胃癌患耆血浆中的CCL18水平显著高于正常人，并能反映胃癌的进展，有助于对胃癌患者进行术前评估及预后判断，具有一定的临床意义和价值。

Background and purpose： CC ehemokine ligand 18 （CCL18） is a human chemokine secreted by monocytes and dendritic cells（DC）. CCL18 primarily targets lymphocytes and immature DC. contributes to the physiological homing of lymphocytes and DC, and generate primary immune responses. Furthermore, enhanced CCL18 production has been demonstrated in several diseases, including Gaueher disease, atopic dermatitis and sume malignancies such as acute lymphoblastic leukemia （ALL） in pediatric patients. The expression of CCL18 in patients with gastric cancer and its correlation to staging remains unknown. Methods： 60 patients with pathological proved gastric cancer were enrolled into the group before operation, and the level of CCL18 in peripheral blood was detected bv enzyme-linked immunusorbeniassay （ ELISA）. Peripheral blood from 20 healthy people were also examined as normal control. Results： The level uf CCL18 in peripheral blood of patients with gastric cancer were significantly higher thau that in healthy people [ （ 115.94 ＋- 22.56） pg/ ml vs （42.46 ＋- 13.97）pg/ml, P = 0. 000）]. The level of CCL18 inversely correlated with N staging, TNM staging and positively correlated with histological grade, and the levels of CCL18 were no difference between the patients with stage Ⅲ/ Ⅳ and healthy people. Conclusions： The level of CCL18 was higher in plasma of gastric cancer patients than in heahhy people. it could also be associated with tuntor progression at different phases and may play an important role in cancer evaluation and prognosis.