结直肠癌患者血清中瘦素表达的研究

Expression of Obesity Hormone Leptin in Human Colorectal Cancer

目的探讨血清瘦素水平与结直肠癌各种临床病理改变的关系。方法用双抗体夹心ABC-ELISA法检测30例无营养不良的结直肠癌患者(肿瘤组)和24例健康成年人(对照组)血清瘦素水平,分析结直肠癌不同临床病理特征下血清瘦素水平的差异;检测肿瘤组患者的血清CEA及CA19-9水平,用RT-PCR方法测定肿瘤组肿瘤标本中K-ras、p53、腺瘤性结肠息肉病(APC)基因及结直肠癌缺失基因(DCC)mRNA的表达水平。结果肿瘤组血清瘦素水平〔(3.53±1.72)μg/L〕明显高于对照组〔(2.27±1.01)μg/L〕,P<0.05,且这种差异与性别无关。肿瘤组中不同肿瘤部位、不同TNM分期间的血清瘦素水平差异无统计学意义(P>0.05);但随着肿瘤分化程度的降低,血清瘦素水平呈现下降趋势,其中低分化者的血清瘦素水平明显低于高分化者和中分化者(P<0.05)。肿瘤学的相关性分析结果显示,血清瘦素水平与结直肠癌患者的血清CEA和CA19-9水平,肿瘤组织的癌基因K-ras以及抑癌基因p53、APC和DCC的表达均无相关性(P>0.05)。结论结直肠癌患者血清中的瘦素水平高于正常人;肿瘤的分化程度影响了血清瘦素的表达,但结直肠癌的TNM分期、部位和血清肿瘤标志物的水平与血清瘦素水平无关,与结直肠癌发生、发展密切相关的各种基因的表达与血清瘦素水平也无关。

Objective To evaluate the relationship between leptin level in serum and clinicopathologic features of colorectal cancer. Methods ABC-ELLSA was used to detect the leptin level in 30 cases of eolorectal cancer without dystrophy （cancer group） and 24 normal controls （control group）. The expressions of K-ras, p53, adenomatous polyposis coli （APC） gene and delete in colorectal carcinoma gene （DCC） mRNA of the tumor were examined by RT-PCR, the levels of serum CEA and CA19-9, and other clinicopathologic features were also recorded. Results The leptin level in cancer group [（3.53±1.72） μg/L] was higher than that in control group [（2.27±1.01） μg/L], P〈0.05, and the difference was independent on gender. There were no significant differences of leptin level in different tumor stages and different tumor location （P〉0.05）. Leptin level of poorly differentiated tumor was obviously lower than that of well differentiated and moderately differentiated tumor （P〈0.05）. There were no associations between leptin level and the levels of CEA and CA19-9, likewise there were no associations between leptin level and the expressions of K-ras, p53, APC and DCC in tumor （P〉0.05）. Conclusion The leptin level of colorectal cancer patient is higher than that of normal person, which is affected by the differentiation of tumor. But there are no sig- nificant correlations between the level of leptin in serum and TNM stage, tumor location, tumor markers of serum, K-ras, p53, APC or DCC in tumor.