胃癌患者TNFα水平及其影响因素

Influencing factors on TNFα level in patients with gastric cancer

目的研究胃癌患者外周血单个核细胞（ＰＢＭＣ）由细菌内毒素（ＬＰＳ）诱导产生ＴＮＦα的能力及胃癌患者自身血浆和吲哚美辛对产生ＴＮＦα的影响．方法采用ＥＬＩＳＡ法测定３６例胃癌患者（男２７例，女９例，年龄３８岁～７１岁，平均５２岁；其中，Ⅰ、Ⅱ期１７例，Ⅲ、Ⅳ期１９例）；２０例良性胃病患者（男１３例，女７例，年龄３２岁～７５岁，平均４９岁）；及２０例正常人（男１２例，女８例，年龄２５岁～５２岁，平均４７岁）ＰＢＭＣ经ＬＰＳ诱导培养上清液中ＴＮＦα水平．胃癌患者ＰＢＭＣ又给予另外两种处理：胃癌自身血浆＋ＬＰＳ和吲哚美辛＋ＬＰＳ．结果ＴＮＦα水平（μｇ／Ｌ）胃癌组（３０４±１６６）较良性胃病组（１０３±０６２）与正常组（０７６±０５７）均显著升高（Ｐ＜００５），良性胃病组与正常组之间无显著差异（Ｐ＞００５）；胃癌患者的不同病理分型间、分期间亦无显著差异（Ｐ＞００５）．胃癌组ＰＢＭＣ经ＬＰＳ诱导加自身血浆处理则ＴＮＦα水平较仅用ＬＰＳ诱导者显著下降（２０７±０９４，Ｐ＜００５），而经吲哚美辛处理较仅用ＬＰＳ处理者显著升高（６４±３０６，Ｐ＜００１）．结论ＴＮＦα水平可作为胃癌诊断的潜在标?

IM To investigate the factors affecting LPSinduced PBMC production of TNFα in patients with gastric cancer including autologous plasma and indomethacin. METHODS The TNFα in PBMC of 36 patients with gastric cancer, (27 males and 9 females, aged 38-71 years, mean age of 52 years). 20 patients with benign gastric diseases (13 males and 7 females, aged 32-75 years, mean age of 49 years) and 20 normal subjects (12 males and 8 females, aged 25-52 years, mean age of 47 years) was measured by the ELISA method. PBMC of the patients with gastric cancer was cultured with autologous plasma+LPS or indomethacin (IM)+LPS. RESULTS The TNFα level (μg/L) in gastric cancer group (304±166) was significantly higher than that of the normal control (076±057) and the benign gastric disease groups (103±062) (P<005). There was no difference of TNFα level in different pathological types and stages of cancer patients. When PBMC of cancer patients was incubated with LPS plus the patients plasma, TNFα production was drastically suppressed (207±094,P<005); however, when IM was added, TNFα production was enhanced significantly (64±306, P<001).CONCLUSION TNFα level may be a potential diagnostic marker in patients with gastric cancer. In addition, the cancer patient plasma may affect the modulation of TNFα production; and IM may raise the TNFα level.