组织多肽特异性抗原在消化系统恶性肿瘤中临床应用价值初探

Serum tissue polypeptide specific antigen level in patients with carcinoma of digestive system

目的 探讨血清组织多肽特异性抗原 (TPS)在消化系统恶性肿瘤中的临床应用价值。方法 回顾性分析恶性胃肠道肿瘤手术者 10例、胃肠道肿瘤明确有远处转移者 2 4例和原发性肝癌 34例 ,在手术或各次非手术性治疗前血清 TPS、CEA或 AFP的含量 ,其中 TPS测量方法为 EL ISA,取正常值为 <80 U / L ,后两者为酶免化学发光法 ,正常值均为 <10μg/ L。结果 早期恶性胃肠道肿瘤 TPS阳性率为 4 0 .0 % (4/ 10 ) ,高于 CEA(2 0 .0 % ) ,但仅低度增高 ,平均值为 (89.6± 38.9) U / L。伴有远处转移者 ,阳性率提高到 95 .8% (2 3/ 2 4 ) ,明显高于 CEA(6 2 .5 % ) ,平均 TPS值为 (6 2 3.3± 4 32 .7) U / L (与早期患者比较 t=5 .98,P<0 .0 5 ) ,与 CEA的相关性为 0 .5 1。原发性肝癌阳性率 10 0 .0 % (34/ 34) ,高于 AFP(6 1.8% ) ,平均值为 (6 15 .4± 4 11.5 ) U / L (与早期恶性胃肠道肿瘤患者比较 t=7.34,P<0 .0 5 ) ,与 AFP相关性为 0 .31。结论 血清 TPS水平有助于判断消化系统恶性肿瘤转移程度。

Objective To assess the clinical role of serum tissue polypeptide specific antigen (TPS) in patients with carcinoma of digestive system.Methods The level of serum TPS was measured by a ELISA method in 10 early and 24 advanced gastrointestinal cancer,34 primary liver cancer patients before treatment and CEA or AFP level in serum was determined by chemiluminescence immunoassay method. The cut off levels were 80 U/L for TPS and 10 μg/L for CEA and AFP.Results Serum TPS levels before therapy in the early patients had a relatively low positivity rate of 40.0%(4/10) with a mean value of (89.6±38.9)U/L,while the level in the advanced had a positivity rate as high as 95.8%(23/24) and the live cancer had the rate of 100%(34/34) with the mean level of (623.3±432.7)U/L( t =5.98, P <0.05) and (615.4±411.5)U/L ( t =7.34, P <0.05),respectively. By contrast,CEA in the two groups of gastrointestinal cancer and AFP in liver cancer had a positivity rate of 20.0%(2/10),62.5%(15/24) and 61.8%(21/34),respectively. The correlation between TPS and CEA in the patients with gastrointestinal carcinoma was 0.51 while the one between TPS and AFP in liver cancer patients was 0.31.Conclusion The study indicates that TPS is helpful in distinguishing patients with advanced gastrointestinal carcinoma from patients with early lesions.