老年大肠癌患者血清胰岛素样生长因子Ⅱ的变化及临床意义

Changes and clinical significance of serum level of insulin-like growth factor Ⅱ in the elderly patients with colorectal cancer

目的研究血清胰岛素样生长因子Ⅱ（IGF-Ⅱ）在老年人大肠癌发展过程中的变化及其临床意义。方法应用放射免疫及电化学发光分析法检测48例大肠癌、32例大肠腺瘤、20例健康者血清IGF-Ⅱ、血清癌胚抗原（CEA）、糖类抗原19-9（CA19-9）的含量。结果老年大肠癌、大肠腺瘤组血清IGF-Ⅱ水平分别为（1.05±0．45）μg／L和（0．79±0．24）μg／L，明显高于健康对照组（0．50±0．15）μg／L（P〈0．01），大肠癌较大肠腺瘤增高更显著（P〈0．05）。大肠癌患者中，Dukes分期A、B、C3期IGF-Ⅱ水平分别为（0．87±0．26）μg／L、（0．95±0．35）μg／L和（1．21±0．45）μg／L，较对照组显著增高（P〈0．01），D期为（0．51±0．25）μg／L，增高不明显（P〉0．05），并较前3期显著下降（P〈0．01）；大肠癌不同肿块大小、解剖部位及分化程度间差异无统计学意义（P〉0．05）。联合检测IGF-Ⅱ、CEA、CA19-9较单项检测阳性率显著提高（P〈0．05）。结论IGF-Ⅱ与老年人大肠癌的发生、发展有密切关系，与CEA、CA19-9联合检测，可显著提高大肠癌的诊断阳性率。

Objective To investigate the changes and clinical significance of the level of serum insulin-like growth factor Ⅱ （IGF-Ⅱ ） in the elderly patients with colorectal adenomas and carcinoma. Methods The serum levels of IGF- Ⅱ , CEA and CA19-9 were determined by radioimmunoassay and electro-chemiluminometry method in 48 patients with colorectal carcinoma, 32 patients with colorectal adenomas and in 20 healthy people as control. Results The IGF-Ⅱ level in patients with colorectal carcinoma or adenomas were （0.79 ± 0. 24）μg/L and（ 1.05 ± 0. 45）μg/L respectively, which were significantly higher than that in controls（0. 50 ± 0. 15）μg/L （all P〈0.01 ）, and higher in colorectal carcinoma than in adenomas（P〈0.05）. In the elderly patients with colorectal cancer, the serum levels of IGF-Ⅱ in staging of Dukes A and B and C were （ 0. 87 ± 0. 26 ） μg/L , （0.95±0.35μg/L and （ 1.21±0. 45）/μg/L,which were significantly higher than those in controls （P〈0. 01 ） , and was （0. 51±0. 25）μg/L in Dukes D, in which no significant difference was found between Dukes D and controls（P〉0. 05）, and it was lower in Dukes D than in Dukes A and B and C （P〈0. 01）. There was no significant difference in size, anatomical site or degree of dysplasia of the cancer （P〉0. 05）. Additionally,the sensitivity of combined IGF-Ⅱ , CA19-9 and CEA detection was higher than that of single item in patients with colorectal cancer （P〈0. 05 ） . Conclusions IGF-Ⅱ may contribute to the occurrence and development of colorectal cancer in the elderly patients. And the combined detection of IGF-Ⅱ and CEA and CA19-9 is an useful adjuvant diagnostic measure for colorectal cancer.