细胞质胸苷激酶TK1对结直肠癌术前诊断及术后随访价值的研究

Research of thymidine kinase1(TK1) in diagnosis and follow-up of colorectal carcinoma

目的探讨细胞质胸苷激酶TK1对结直肠癌术前诊断及术后随访的价值。方法利用增强化学发光法(ELISA)和免疫组织化学法分别检测140例结直肠癌患者术前血清中TK1、癌胚抗原(CEA)水平及手术切除标本中TK1的水平,观察上述3种方法诊断结直肠癌的阳性率,同时比较TK1联合CEA较单一应用CEA诊断阳性率的变化。随访患者术后1、3、6个月TK1的水平,观察其动态变化规律。结果 TK1组织化学法诊断结直肠癌的阳性率为78%,分别与血清TK1、CEA比较阳性率均有显著性差异(P<0.05)。血清TK1联合CEA诊断的阳性率为72.0%,联合诊断较单一方法诊断的阳性率有显著提高(P<0.05)。结直肠癌患者手术后1、3、6个月血清TK1水平较术前均有明显下降(P<0.05)。6个月血清TK1水平接近正常人群。结论 虽然组织TK1的检测方法阳性率最高,但其操作繁琐,费时。而血清TK1操作简便易行,是继癌胚抗原(CEA)后又一个结直肠癌的辅助诊断、监测疗效的方法,临床可望广泛应用。

Objective To observe the value of thymidine kinase（TK1） on diagnosis and follow-up of colorectal carcinoma.Methods The levels of CEA,TK1 in serum and TK1 in tissue specimen in 140 patients with colorectal carcinoma were determined by enhanced chemi-luminescence assay and immunohistochemistry to observe positive rate of colorectal carcinoma.The combination of TK1 and CEA was compared with serum CEA to determine the better diagnostic method.Then serum TK1 was tested 1,3 and 6 months respectively after surgical operation.Results Positive rate of serum TK1 in diagnosis of colorectal carcinoma was 63.8% while CEA was 59.3%,immunohistochemistry was 78% which had significant difference with CEA and TK1 respectively（P〈0.05）.The combination of serum TK1 and CEA increased the positive rate of diagnosis to 72.0% which had significant difference with CEA（P〈0.05）.The level of serum TK1 was decreased gradually after surgical operation in 1,3 and 6 months compared to pre-operation.It almost reached the normal level after 6 months.Conclusion Though immunohistochemical method is the most sensitive one in diagnosis of colorectal carcinoma,it is complicated and difficult to operate. Serum TK1 can be used as assistant method to colorectal carcinoma diagnosis for its simplicity and stability.Hopefully,TK1 may be widely used in clinical work.