肺癌患者手术前后血清p53抗体的动态变化及其临床意义

Pre- and post-operative sequential changes of serum p53 antibodies and clinical significance in patients with lung cancer

目的 探讨肺癌患者血清p5 3抗体与临床病理特征之间的关系 ,以及手术后p5 3抗体的动态变化规律。方法 采用酶联免疫吸附法 (ELISA)分别于术前 1天、术后 7、3 0、90天动态检测 12 0例肺癌患者血清p5 3抗体 ,并以 3 0例肺部良性疾病患者和 12 0例正常健康人作对照。结果 肺癌患者血清p5 3抗体水平和阳性率均明显高于肺部良性疾病患者和正常人 (P <0 .0 5 ) ,而正常人与肺部良性疾病患者间无显著性差异 (P >0 .0 5 )。肺癌患者血清p5 3抗体水平和阳性率均与肺癌细胞分化程度和病期有密切关系 (P <0 .0 1或P <0 .0 5 )。在行根治性切除术后 ,肺癌患者血清p5 3抗体水平逐渐降低 ,术后 3 0天左右可降至正常人水平 ;而行姑息性切除者 ,术后 3 0天血清p5 3抗体水平不能降至正常水平 ;如术后有肺癌复发和转移者 ,术后血清p5 3抗体水平可再度升高。结论 检测血清p5 3抗体水平有助于肺部良恶性疾病的诊断 ;手术前后动态测定肺癌患者血清p5 3抗体的变化规律 ,有助于判断疗效 ,监测预后和指导肺癌术后的综合治疗。

Objective To explore the relationship between serum p53 antibodies and clinicopathological characteristics in patients with lung cancer and to investigate sequential changing regularity of serum p53 antibodies after surgical resection. Methods The serum p53 antibody level was detected in 120 patients with lung cancer, and in 30 patients with benign pulmonary lesion and 120 healthy adults as control by enzyme linked immunosorbent assay (ELISA). The blood samples were collected on the day before operation and on the 7th, 30th and 90th days postoperatively. Results The level and positive rate of serum p53 antibodies in patients with lung cancer were significantly higher than those in patients with benign pulmonary disease and normal individuals (P<0.05), but there was no significant difference between patients with benign pulmonary disease and normal individuals (P>0.05). The level and positive rate of pre operative serum p53 antibodies in patients with lung cancer were closely related to cell differentiation and stage of lung cancer (P<0.01 or P<0.05). The level of serum p53 antibodies decreased gradually in patients with lung cancer underwent radical removal of the cancer, and completely returned to the normal level around the 30th day after operation, but the level of serum p53 antibodies in patients with lung cancer underwent palliative operation didn't reduce to the normal level on the 30th day after operation. It would increase again when tumor metastasis or recurrence developed. Conclusion Detection of serum p53 antibodies is helpful to defferentiate benign from malignant pulmonary diseases. Monitoring of sequential change of pre and post operative serum p53 antibodies in patients with lung cancer is helpful to evaluate response to treatment, to judge prognosis and to guide the comprehensive treatment of patients with lung cancer after operation.