胰腺组织及血清VCAM-1、ICAM-1在胰腺癌手术治疗前后的变化研究

The change of VCAM-1, ICAM-1 in pancreatic tissues and serum before and after surgical treatment in pancreatic cancer patients

目的研究胰腺组织与血清血管细胞黏附分子-1(VCAM-1)和细胞间黏附分子-1(ICAM-1)在胰腺癌手术治疗前后的变化。方法选择90例胰腺癌患者(胰腺癌组)、90例急性胰腺炎患者(急性胰腺炎组)和90例同期健康体检者(正常组),于术前和术后第7天检测3组患者血清可溶性血管细胞黏附分子-1(s VCAM-1)、可溶性细胞间黏附分子-1(s ICAM-1)、糖链抗原19-9(CA19-9)和癌胚抗原(CEA)水平;胰腺癌组和急性胰腺炎组患者均于术中切取胰腺典型部位组织行VCAM-1、ICAM-1水平检测,并对上述指标进行分析。结果术前和术后第7天,胰腺癌组患者血清s VCAM-1、s ICAM-1、CA19-9和CEA水平均高于急性胰腺炎组、正常组,差异均有统计学意义(P﹤0.05)。术前,急性胰腺炎组患者血清s VCAM-1、s ICAM-1、CA19-9和CEA水平均高于正常组,差异均有统计学意义(P﹤0.05)。术前,胰腺癌组中胰腺组织VCAM-1、ICAM-1水平均明显高于急性胰腺炎组,差异有统计学意义(P﹤0.01)。术后第7天,急性胰腺炎组患者血清s VCAM-1、s ICAM-1、CA19-9、CEA水平与正常组比较,差异无统计学意义(P﹥0.05)。胰腺癌组中,术后第7天患者血清s VCAM-1、s ICAM-1、CA19-9和CEA水平均明显低于术前,差异有统计学意义(P﹤0.01)。胰腺癌组患者血清s VCAM-1、s ICAM-1与CA19-9均呈正相关(P﹤0.05);胰腺癌组患者血清s VCAM-1、s ICAM-1与CEA无相关性(P﹥0.05)。结论胰腺癌患者的血清s VCAM-1、s ICAM-1水平明显升高,术后迅速降低,其血清s VCAM-1、s ICAM-1与CA19-9呈正相关,在早期诊疗胰腺癌过程中有较高的应用价值。

Objective To study the changes of vascular cell adhesion molecule-1（VCAM-l） and intercellular adhesion molecule-1（ICAM-1） in pancreatic tissue and serum before and after surgical treatment for pancreatic carcinoma.Method 90 cases of pancreatic cancer（pancreatic cancer group）, 90 cases of acute pancreatitis（acute pancreatitis group）and 90 healthy adults（control group） were included in the study and detected for serum soluble vascular cell adhesion molecule-1（s VCAM-l） and soluble intercellular adhesion molecule-1（s ICAM-1）, carbohydrate antigen 19-9（CA19-9）,and carcinoembryonic antigen（CEA） levels before and 7 days after surgery; pancreatic cancer group and acute pancreatitis group were taken typical samples of pancreas tissues during surgery for VCAM-1 and ICAM-1 detection, and were analyzed accordingly. Result Before surgery and 7 days after surgery, the s VCAM-l, s ICAM-1, CA19-9, and CEA levels were higher in pancreatic cancer group as compared with those in acute pancreatitis group and control group, and the differences were of statistical significance（P〈0.05）. Before surgery, acute pancreatitis patients had higher levels of s VCAM-l,s ICAM-1, CA19-9, and CEA than control group, with significant differences observed（P〈0.05）. Before surgery, the VCAM-l and ICAM-1 levels were higher in pancreatic cancer group as compared with those in acute pancreatitis group,and the differences were of statistical significance（P〈0.01）. In 7 days after surgery, the four indicators became similar with those in control group（P〈0.05）. As of pancreatic cancer group, the levels of s VCAM-l, s ICAM-1, CA19-9, and CEA were decreased in 7 days after surgery as compared with before, and statistically significant difference was observed（P〈0.01）. For pancreatic cancer patients, positive correlation was determined between s VCAM-l, s ICAM-1, and CA19-9（P〈0.05）; while s VCAM-l and s ICAM-1 was independent of CEA（P〈0.05）. Conclusion In pancreatic cancer patients,the levels of s VCAM-1 and s ICAM-1 in serum are significantly increased, and then decrease rapidly after surgery, besides, the s VCAM-1 and s ICAM-1 in serum are positively correlated with CA19-9, which is essential in the early diagnosis and treatment of pancreatic cancer.