血清25-(OH)D水平在胃癌患者中的临床意义

Clinical Significance of Serum 25-Hydroxyvitamin D Level of Gastric Cancer Patients

目的研究血清25-羟基维生素D[25-（0H）D]水平在胃癌患者中的临床意义，并且探讨血清25-（0H）D与胃癌进展的关系。方法采用免疫电化学发光法检测胃癌患者和健康对照者的血清25-（0H）D浓度，进行统计学分析，比较胃癌患者和健康对照者的血清25-（OH）D浓度有无统计学差异，比较不同临床分期、组织分化程度、肿瘤大小、远行转移等指标下对应的胃癌患者血清25-（OH）D水平的差异有无统计学意义。结果胃癌组血清25-（OH）D水平（10．12±5．78ng／m1）显著低于对照组（18．12±7．36ng／ml）（t=8．51，P〈0．001）。胃癌Ⅰ期的血清25-（0H）D水平显著高于胃癌Ⅲ期（P=0．01）和胃癌Ⅳ期（P=0．006）的水平。胃癌高分化组患者的血清25-（OH）D水平显著高于中分化、低分化和未分化组的水平（均P〈0．001）。血清25-（OH）D水平与胃癌淋巴结转移、远行转移、肿瘤大小、肿瘤位置均无显著相关性（均P〉0．05）。结论胃癌患者25-（OH）D比健康对照者低；胃癌的临床分期越晚，维生素D水平越低；组织学分化程度越低，维生素D水平越低。

Objective To explore the significance of serum 25-hydroxyvitamin D[-25-（OH）D] level and the risk of gastric cancer,and investigate the correlation between 25-（OH）D level and the clinic-pathological characteristics of patients with gastric cancer. Methods The immune-chemiluminescence method was used to measure the serum 25-（OH）D level in order to compare the difference of gastric cancer patients and healthy controls. The general features of patients with gastric cancer （such as age, gender, nationality, sampling season, smoking and drinking status） and clinic-pathological data （such as clinical stage, histological differentiation, lymph node metastasis, tumor size, tumor metastasis, tumor site） were collected. Explored the relationship between various clinic-pathological features and 25-（OH）D level in gastric cancer patients. Analysis of variance and t-test were used to compare the differences of 25-（OH）D level at various indexes such as clinical stage,differentia- tion degree,tumor size and metastasis. Results 25-（OH）D level was 10.12＋-5.78 ng/ml and 18.12＋-7.36 ng/ml in gastric cancer group and control group, respectively. Serum 25-（OH）D level of the gastric cancer group was significantly lower than that in the control group （t= 8.51, P〈0. 001）. There was a significant difference of serum 25-（OH）D in different clinical stages of gastric cancer patients （F= 3.26, P = 0. 025）. Serum 25-（OH）D level of Gastric cancer stage I patients was signif- icantly higher than that of stage Ⅲ （P= 0.01） and stage Ⅳ （P= 0. 006）. With the improvement of the tumor differentiation,serum 25-（OH）D levels showed an increasing trend. Serum 25-（OH）D level of high differentiated group was significantly higher than that of low differentiation,moderate differentiated and undifferentiated group （P〈0. 001）. No significant relationship were found between serum 25-（OH）D level and lymph node metastasis, tumor metastasis, tumor size, and tumor site （P〉0.05）. Conclusion Serum 25-（OH）D level represented the vitamin D status of the body. This study elucidated the vitamin D level in patients with gastric cancer was lower than that in healthy controls. Low vitamin D level may be the prediction of high risk of gastric cancer. The later clinical stage, the lower vitamin D level. The poorer the histological differentiation degree,the lower level of vitamin D.