中晚期胃癌患者化疗前后血清可溶性上皮钙黏附蛋白检测的临床意义

Significance of the detection of serum soluble cadherin in patients with middle-advanced gastric cancer before and after chemotherapy

目的探讨血清可溶性上皮钙黏附蛋白（sE-cad）与癌胚抗原（CEA）、糖类抗原199（CAl99）评价中晚期胃癌患者化疗效果的临床意义。方法以40例健康人为对照组和58例中晚期胃癌患者为观察组，检测对照组和观察组化疗前及化疗后第8周的血清中sE—cad、CEA、CAI99的水平，分析其水平变化与化疗疗效的关系。结果观察组患音化疗前血清sEcad、CEA、CAl99均显著高于健康对照组（P〈0．05）。观察组化疗后获有效缓解为25人（有效组）．无效缓解为33人（无效组）。化疗前有效组患者的血清sE—cad水平显著高于无效组（P〈0．05）。化疗后有效组患者的血清sE—cad水平显著低于化疗前（P〈0．05），无效组患者的血清sE—cad较化疗前显著升高（P〈0．05）。而CEA与CAl99在观察组化疗前后均无显著变化（P〉0．05）。结论血清sE-cad能够反映中晚期胃癌患者化疗疗效，且化疗前血清sE-cad水平高的疗效较好，对中晚期胃癌患者的诊断及病情和预后评价具有有一定参考价值。

Objective To investigate the evaluation significance for chemotherapy in patients with middle-ad- vanced gastric cancer with the serum soluble cadherin（sE-cad）,CEA and CA199. Methods First,40 healthy human were considered to be the controls group and the 58 patients with middle-advanced gastric cancer were the observation group. And then,the level of serum sE-cad,CEA and CA199 were test in the controls group and the observation group before chemotherapy, as well as the observation group at the time of eighth week after chemotherapy. Last, the data were analyzed for their relationship of serum sE-cad,CEA and CA199 and the chemotherapy effect in patients with middle-advanced gastric cancer. Results The level of serum sE-cad,CEA and CA199 in the observation group before chemotherapy were significantly higher than the control group（P〈0.05）. After the treatment of chemotherapy, 25 patients in the observation group got validly remission（validly group）, and the other 33 patients got invalid remission（invalidly group）. Before chemotherapy,The level of sE-cad in validly group were significantly higher than the invalidly group（P〈0.05）. The level of sE-cad in validly group were significantly lower than they treated before chemotherapy（P〈0.05）, and in validly group were significantly higher than before（P〈0.05）. However, The level of CEA and CA199 were no significant change in the observation group before and after chemotherapy（P〉0.05）. Conclusion The level of serum sE-cad can reflect the efficacy of chemotherapy in patients with middle-advanced gastric cancer. Especially,the efficacy is better in high levels of sE-cad. These can help the doctor for diagnosis and prognosis in patients with middle-advanced gastric cancer.