尿中游离L-岩藻糖测定的临床应用

Clinical Application for Determination of Free L-FC in Urine.

采用日本宝酒造公司生产的Ｌ岩藻糖监测试剂盒及质控标准品， 用酶分析法在自动生化分析仪上对８６ 例正常健康者和２０５ 例不同肿瘤患者尿中的ＵＦＣ 水平进行检测， 结果显示， 健康组尿中ＵＦＣ水平： ｘ ＝ １７７７，ｓ＝５６６ ，９５ ％ ， 可信限范围是６３８～２９０２ μｍｏｌ／ｇｃｒ ； 肝癌、肝硬化、急慢性肝炎、胰腺癌、食管癌、胃癌、肠癌、肺癌患者尿中ＵＦＣ均值大于２９０ μｍｏｌ／ｇｃｒ ． 与正常健康组对照， 有非常显著性差异； 乳腺癌、宫颈癌、卵巢癌患者的ＵＦＣ与健康组比较， 有显著性差异． 尿中游离Ｌ岩藻糖测定方法简便、快速、能自动化、取样方便， 并提示尿中ＵＦＣ水平的变化可视为肝癌、急慢性肝炎癌变的特异性指标之一， 也是消化系统癌症病人肿瘤标记物试验之一．

L fucose (L FC),6 deoxygalactose, is one of rare sugars which naturally exists in the form of L isomer. L fucose plays an important role in their physiological and biological functions. It has been well known that L FC is attached to glycochains of tumor markers such as alpha fetoprotein (AFP) and CA 199. Increment of α L fucosidase was detected in patients with primary hepatic carcinoma. Fucolipid accumulation in human adenocarcinoma was abnormally increased and fucosyltransferase was highly active in lung cancer cells. In addition,it has been found that patients with liver cancer and cirrhosis excreted free L fucose via urine to greater extent than normal individuals. The values of UFC were detected in the urine from 86 health people and 205 people with various tumors. The mean value of urinary L FC in health people was 177 7 μmol/g cr( s =56 6, 95% confidence range was 63 8～ 290 2 μmol/g cr ). The mean values of UFC in urine obtained from patients with hepatocellular carcinoma , cirrhosis, acute and chronic hepatitis, pancreas carcinoma , gastric cancer, lung cancer , intestinal cancer, esophageal cancer were higher than 290 2 μmol/g cr , having significant difference from normal individuals. The mean values of UFC in urine obtained from patients with mastadenoma, cervical cancer and ovary cancer have significant difference from normal individuals. The value of L fucose in urine can be regarded as one of the characteristic indexes for hepatocellular carcinoma and canceration of acute and chronic hepatitis. Detection for L fucose is one of tumor marker tests for patients with tumor in digestive system.