胃癌外周血sTNFR-1检测及临床意义

The Measurement and Clinical Significance of Soluble Tumor Necrosis Factor Receptor 1(sTNFR-1)in Peripheral Blood of Gastric Carcinoma

目的 :探讨胃癌患者外周静脉血可溶性肿瘤坏死因子受体 - 1(sTNFR 1)水平及临床意义。方法 :应用ELISA方法对 4 9例胃腺癌患者于术前 1d、术后 14d分别采集外周静脉血检测sTNFR 1水平 ,并以正常献血者为对照组。所有病例随访 2年以上。结果 :①胃癌外周静脉血术前、术后sTNFR 1均高于正常对照组。②术前外周静脉血sTNFR 1水平与肿瘤浸润深度、有无淋巴结转移无关 ;与肿瘤分化程度、有否远处转移、UICC分期、是否行根治手术有关 ,低～未分化、有远处转移、UICC分期IV期及姑息性手术组sTNFR 1水平明显高于高～中分化、无远处转移、UICC分期Ⅰ～Ⅲ期及根治性手术组。③术后 2周血sTNFR 1水平在术后 1年内肿瘤复发或死亡组较术后 1年内无肿瘤复发组明显增高 ;术后 2周sTNFR 1水平未降至正常 4 0例 ,术后 1年内复发或死亡 2 8例 (70 % ) ,明显高于术后降至正常组 (2 92 2 .2 % )。结论 :胃癌患者存在高水平的sTNFR 1,肿瘤分化程度差、已有远处转移患者增高更加明显 ,术后仍维持高水平的sTNFR

Objective To study the clinical significance of serum soluble tumor necrosis factor receptor Ⅰ(sTNFR 1) in gastric carcinoma.Methods The levels of sTNFR 1 of peripheral blood were analyzed with ELISA method in 49 patients with gastric carcinoma the day before operation and the 14 th day after gastrectomy.All patients were followed up for more than two year after operation.Results ① The levels of sTNFR 1 of preoperation and postoperation in patients with gastric carcinoma were higher than in control groups.② The preoperative levels of sTNFR 1 were not related to tumor invasive depth,lymph node,but related to histological differentiation,distance metastasis,UICC stage and radical resection respectively.The concentration of sTNFR 1 was significantly higher in patients with poor differentiation,metastasis?UICC stage Ⅳ or no radical resection than in patients with well differentiation,no metastasis,UICC stage Ⅰ-Ⅲ and radical resection.③ The postoperative levels of sTNFR 1 after two weeks in the group that the patients had recurrent or died within one year were higher than that in group without recurrent or died.28 of 40 patients (70%) with elevating sTNFR 1 levels in postoperation had recurrent or died within one year after operation,that recurrent rate was higher significantly than that in normal postoperative sTNFR 1 levels (2/9,22.2%).Conclusions Patients with gastric carcinoma have elevated sTNFR 1 level in peripheral veins,and that level is higher significantly in patients with poor differentiation and distant metastasis.Continuous elevating level sTNFR 1 after operation might suggested early recurrent or short life expectance and poor prognosis.