血清唾液酸测定在预防性体检及肿瘤监测中的应用——唾液酸系统研究

The use of serum sialic acid assay in health surveillance and tumor monitoring

目的 探讨血清总唾液酸（ＴＳＡ） 在预防性体检中应用的可行性及评价其监测恶性肿瘤的临床意义。方法 用化学比色法测定健康年检工人血清ＴＳＡ，分析４８２ 名ＴＳＡ 可疑阳性或阳性工人健康状况，研究２ ３０３ 名交警血清ＴＳＡ 与职业健康监护评定标准的关系、随访１０ ３７３ 名２ ～４ 年前测定血清ＴＳＡ 工人的健康状况、临床观察９４ 例恶性肿瘤患者ＴＳＡ 水平治疗前后变化。结果 （１）ＴＳＡ 在预防性体检中表明：①在４８２ 名ＴＳＡ 可疑阳性或阳性受检者中，肿瘤患者（１０ 例，２－５０ ±０－２１ ｍｍｏｌ／Ｌ） 血清ＴＳＡ 水平高于慢性疾病患者（２４０ 例，２－３９ ±０－２５） ，而后者又明显高于未患病的追踪观察者（２３２ 例，２－１４ ±０－２４） ，Ｐ＜ ０－００１ ；②按照广州市职业健康监护标准发现２ ３０３ 名广州交警血清ＴＳＡ 水平健康组明显低于异常组、追踪观察组和尚健康组，Ｐ＜ ０－０５ 或Ｐ＜ ０－００１ ；③随访发现，原ＴＳＡ 可疑阳性或阳性者新患恶性肿瘤和非恶性肿瘤疾病者明显高于ＴＳＡ 阴性者（ Ｐ＜ ０－００１） 。（２） 在肿瘤监测中发现：９４ 例恶性肿瘤患者ＴＳＡ 水平明显高于健康对照组，病人治疗后病情稳定或好转者ＴＳＡ

Objective To explore thefeasibility ofthe serum totalsialic acid (TSA) assayin health surveillance and evaluate the clinical significance in monitoring malignant tumor.Methods TSA was measured by chemical col orimetry .Subjectsincluded 482 workers with positive orsuspectedly positive TSAlevels out of12 629 workers measured from March ,1995 to June,1996 ;10 373 workers asfollow up cases;2 303 traffic policemen ;94 patients with malig nanttumor and 470 healthy controls. Results (1) TSAusing in health surveillance showed :①Of 482 workers whose TSAlevels were positive or suspected positive ,TSA concentrations were in order oflevels from high to low ,e .g .10 workers with malignanttumor (2 .50 ±0 .21) ,240 workers with various chronic diseases (2 .39 ±0 .25) and 232 follow - up workers (2 .14 ±0 .24) ,P< 0 .001 ; ②Of 2 303 traffic policemen ,TSAlevels in abnormal group ,follow - up group andfairhealth group wererespectively higherthanthatin health group , P< 0 .05 , or P< 0 .001 . ③Follow - up study on 10 373 workers whose TSAlevels were measured 2 ～4 yearsagoindicated thattheincidence of malignanttumor and orther diseasedin TSAlevels positive orsuspected positive group was higherthan thatin TSAlevels negative group respectively , P< 0 .001 .(2) Study on malignanttumorshowed :TSAlevelsin patients with malignanttumor werestatis tically higherthanthose in healthy controls ( P< 0 .001) .TSAlevels ofpost- therapy patients with stable and effective result were significantlylowerthanthose ofpre -therapy ( P< 0 .001) .However,there was an oppositeresultsin those worsened or dead patients. Conclusion TSA might be used as a generalindex of health levels or a predicted one of high risk population and might be also used as one ofthe malignanttumor markers and a predicted indexfor monitoring the therapeutic effectofthe patients with malignanttumor.