胃癌患者血清和组织中sIL-2R水平的临床观察及其意义

Clinical Study on Serum and Tissue Levels of sIL-2R in Patients with Gastric Cancer and Their Significance

目的 研究胃癌患者血清及组织中可溶性白细胞介素 2受体 (sIL 2R)变化的临床意义。方法 采用双抗体夹心ELISA法 ,对 5 8例胃癌患者手术前后、32例胃良性疾病患者 (慢性浅表性胃窦炎患者 2 6例 ,功能性消化不良 6例 )及 36例健康体检者血清sIL 2R水平进行检测 ;同时检测了胃癌及胃良性疾病者活检组织中sIL 2R的浓度。结果 胃癌患者血清sIL 2R(U /L)为 911± 179,明显高于胃良性疾病者 (30 3± 2 0 )和健康体检者 (30 1± 15 ) ,P <0 .0 0 1。胃癌组织中sIL 2R为 934± 197明显高于胃良性疾病胃粘膜组织 (311± 2 0 ) ,P <0 .0 0 1。胃癌按Ⅰ～Ⅳ级分期的不同 ,sIL 2R在血清和组织中逐渐增高 ,且各期之间进行比较均P <0 .0 0 1;其中Ⅰ期 (11例 )、Ⅱ期 (10例 )、Ⅲ期 (2 2例 )术后血清sIL 2R明显下降 (各自P <0 .0 0 1) ;而Ⅳ期患者 (15例 )手术前后无明显变化且有所增高 ;手术切除组 (46例 ,根治或姑息手术 )术后sIL 2R明显降低 (P <0 .0 0 1) ,而探查者或胃空肠吻合术者 (12例 ) ,术后血清sIL 2R反而增高。结论 动态观察血清及组织sIL 2R的变化可作为胃癌的诊断、手术方法的选择、疗效评价及预后监测有意义的参考指标。

Objective To study the changes of serum and tissue soluble interleukin 2 receptor(sIL 2R) in gastric cancer patients and their clinical significance.Method Serum level of sIL 2R was detected by the double antibody sandwich ELISA method in 58 patients with gastric cancer before and after operation,32 benign disorders(26 cases of superficial antral gastritis,6 cases of functional dyspepsia) and 36 controls.Simultaneously,tissue level of sIL 2R was measured in the patients of gastric cancer and benign dilorders.Results (1)The serum sIL 2R level(911±179U/L vs 303±20U/L and 301±15U/L, P <0.001) in gastric cancer patients was significantly higher than those in the benign disorders and healthy controls;(2)The tissue sIL 2R level in the gastric cancer patients was significantly higher than that in the benign disorders( P <0.001);(3)The serum and tissue level of sIL 2R showed statistical difference among the gastric cancer ofⅠ、Ⅱ、Ⅲ、Ⅳ stages(one another comparison P <0.01);(4)The serum sIL 2R level declined remarkably after gastrectomy in Ⅰ、Ⅱ、Ⅲ stages of the gastric cancer( P <0.001),nevertheless in Ⅳ stage of the gastric cancer it was not changed before and after operation;(5)The serum level of sIL 2R declined remarkably after operation of radical or pallitive.Conversely,it increased after exploratory laparotomy and gastroenterostomy.Conclusions Dynamic alterations of serum and tissue sIL 2R level may be used as the indicators of diagnosis,the choice of operative method and judgement of prognosis in patients with gastric cancer.