T抗原检测在大肠腺癌癌前状态中的临床意义

Clinical significance of T-antigen in the premalignant condition of colorectal cancer

目的 探讨T抗原检测在大肠息肉筛选检查和溃疡性结肠炎（溃结）恶变监测中的临床意义。方法用半乳糖氧化酶法对111例大肠息肉病人，24例有大肠息肉病史、原有息肉已摘除、目前无新生息肉病人，28例溃结活动期病人，22例溃结缓解期病人及100例正常人的直肠粘液作T抗原检测。结果大肠息肉病人的T抗原检测阳性率明显高于对照组（P＜0．001）；有息肉病史者的T抗原检测阳性率明显低于有息肉病人（P＜0．001），而与对照组相似（P＞0．05），同时T抗原检测阳性率随增生型腺瘤、管状腺瘤、乳头状腺瘤的恶变倾向增加而增加（16．7％、42．9％、64．7％）。溃结活动期病人的T抗原检测阳性率明显高于溃结缓解期（P＜0．01）和对照组（P＜0．001），而溃结缓解期病人的T抗原检测阳性率与对照组相似（P＞0．05）；病程≥10年的活动期溃结病人与＜10年者相比，T抗原检测阳性率之间有显著差异（P＜0．05），但两者均高于对照组（分别为P＜0．001和P＜0．05）；缓解期、病程〈10年和病程≥10年的溃结活动期病人的T抗原检测阳性率呈增加趋势（13．6％、38．9％、80％）。结论（1）T抗原检测的阳性率与是否存在大肠息肉，特别是肿瘤性息肉有关，与有无息肉病史无关，因此该检测可试用于大肠息肉的筛选检查；摘除大肠息?

To study the clinical significance of T-antigen in screening colorectalpolyps (PC) and in detecting the pathological change of ulcerative colitis (UC) to colorectal cancer.Methods 185 patients (111 with CP, 28 with active UC, 22 with remissive UC, 24 who have had col-orectal adenoma CA) and 100 normal subjects received T-antigen tests with galactose oxidase method.Results The positive rate of T-antigen in CP patients was higher than that in the controls (P<0. 001 ). It was lower in patients having CA history than in those with CA (P<0. 001),but it was nearlythe same as that in the controls (P>0. 05). It increased with the increase of the malignant tendency ofhyperplastic, tubular, papillary adenoma(16. 7 %,42. 9 %, 64. 7 % ). It was higher in active UC patientsthan in remissive UC ones(P<0. 001 ) or in the controls (P<0. 001). It was nearly the same in remissive UC patients as in the controls (P> 0. 8). Conclusion T-antigen detection can be used to screencolorectal polyps and to determine the pathological change of ulcerative colitis to colorectal cancer.[