结直肠癌患者血清中可溶性P-选择素和L-选择素水平及临床意义

Soluble P-selectin and L-selectin levels in serum of colorectal cancer patients and its clinical significance

背景与目的:结直肠癌是常见的消化系统恶性肿瘤,严重威胁着人类的健康。虽然现代诊疗技术不断发展,但近年来结直肠癌的发病率和病死率仍呈逐年上升趋势,早期诊断和防治肝转移有助于提高结直肠癌患者的生存率,对改善其预后有重要意义。P-选择素和L-选择素是近年肿瘤研究领域倍受关注的分子,其表达量及介导的黏附作用的改变在肿瘤细胞转移中起着重要作用,但2者与结直肠癌发生及临床分期的关系鲜见报道。本研究旨在探讨结直肠癌患者手术前后血清中P-选择素和L-选择素水平高低与临床病理特征的相关性。方法:选择132例结直肠癌患者及与其性别年龄相匹配的100名健康体检者。采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测132例结直肠癌患者手术前后血清中P-选择素和L-选择素浓度,100名健康体检者为对照组,结合临床病理特征对P-选择素和L-选择素水平的变化进行分析。结果:结直肠癌患者术前血清P-选择素和L-选择素水平显著高于对照组(75.2±13.3 vs 26.6±9.6,89.2±12.7 vs33.9±8.3,P<0.05);术后1周P-选择素和L-选择素水平较术前没有明显下降(63.8±11.1 vs 75.2±13.3,71.5±10.9 vs 89.2±12.7,P>0.05);而术后3个月则明显下降,与术前比较差异有统计学意义(34.8±10.4vs 75.2±13.3,40.1±9.5 vs 89.2±12.7,P<0.01);本组结直肠癌患者,临床分期越高,P-选择素和L-选择素水平越高,其水平与肿瘤浸润深度、Dukes分期、组织学分级和淋巴结转移相关,而与年龄、性别及肿瘤部位无明显相关(P>0.05);同时,同一结直肠癌患者血清中P-选择素和L-选择素的表达无显著相关(r=4.114,P>0.05)。结论:血清中P-选择素和L-选择素的水平在一定程度上反映了结直肠癌的侵袭、浸润和淋巴结转移的程度,可作为预测结直肠癌发展及预后的重要指标。

Background and purpose：Colorectal cancer is a kind of common digestive malignancies, which seriously threaten the human health. Although modern diagnostic and treatment technology has developed rapidly, the incidence and mortality of colorectal cancer continue to show an increasing tendency in recent years, and early diagnosis and prevention of colorectal cancer liver metastases are important to increase the survival rate of patients and to improve the prognosis. P-selectin and L-selectin is attracting much attention in cancer research ifeld recently, and the change of their expression and mediated adhesion play an important role in tumor cell metastasis, but their relationship between the occurrence and clinical stage of colorectal cancer rarely reported. This study aimed to explore whether the serum P-selectin and L-selectin levels of colorectal cancer patients were correlated with clinical and pathological features and the situation before and after surgery.Methods：A total number of 132 cases of colorectal cancer patients and 100 healthy subjects with gender and age-matched were enrolled. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum P-selectin and L-selectin concentrations in 132 cases before and after surgery, 100 healthy subjects were enrolled as the control group, the P-selectin and L-selectin levels were analyzed combined with theclinical and pathological features.Results：Serum P-selectin and L-selectin levels in patients with colorectal cancer before surgery were signiifcantly higher than those in the healthy control group （75.2±13.3vs 26.6±9.6, 89.2±12.7vs 33.9±8.3,P〈0.05） ; Compared with the patients before surgery, 1 week after surgery, the P-selectin and L-selectin levels were not significantly decreased （63.8±11.1vs 75.2±13.3, 71.5±10.9vs 89.2±12.7,P〉0.05）; however, significantly decreased after 3 months （34.8±10.4vs 75.2±13.3, 40.1±9.5vs 89.2±12.7,P〈0.01）; This paper studied patients with colorectal cancer, the higher clinical stage, higher P-selectin and L-selectin levels, and their expression levels with tumor invasion depth, Dukes stage, histological grade and lymph node metastasis were related, but were not correlated with age, gender and tumor site. Meanwhile, P-selectin and L-selectin levels were not signiifcantly correlated in the same serum of patients with colorectal cancer （r=4.114,P〉0.05）.Conclusion：Serum P-selectin and L-selectin levels to some extent relfect the invasion of colorectal cancer, the degree of inifltration and lymph node metastasis, and which can be an important indicator in the development and prognosis of colorectal cancer.