血清25-(OH)D与结直肠癌患者临床特征的关系

Relationship between clinical characteristics and serum 25-hydroxyvitamin D in patients with colorectal cancer

目的探讨血清25-(OH)D水平与结直肠癌患者临床特征的关系。方法选取结直肠癌患者234例,采用酶联免疫吸附法检测血清25-(OH)D含量,采用电化学发光法测定血清癌胚抗原(CEA)、糖类抗原199(CA199)含量,同时应用免疫组织化学法检测结直肠癌病理组织中血管内皮生长因子(VEGF)、表皮生长因子受体(EGFR)的表达情况。结果结直肠癌患者血清25-(OH)D水平低于正常健康人群,其中女性患者血清25-(OH)D水平显著低于男性患者,右半结肠癌患者血清25-(OH)D水平低于左半结肠和直肠癌患者,肿瘤浸润深度突破肌层的患者血清25-(OH)D水平显著低于未突破肌层患者,TNM分期中T4期患者血清25-(OH)D水平显著低于T1、T2和T3期,N1、N2患者血清25-(OH)D水平低于N0,Ⅱ、Ⅲ、Ⅳ期患者血清25-(OH)D水平低于Ⅰ期,肿瘤分化程度为低分化与中分化患者血清25-(OH)D水平低于高分化者;结直肠癌患者CEA异常组血清25-(OH)D水平低于正常组;VEGF、EGFR阳性表达组血清25-(OH)D水平低于阴性组(P<0.05)。结直肠癌患者年龄、肿瘤类型、肿瘤最大直径以及CA199水平与血清25-(OH)D之间无明显统计学差异(P>0.05)。结论不同性别、肿瘤位置、浸润深度、淋巴结转移、分化程度及临床分期的结直肠癌患者血清25-(OH)D水平存在差异,异常CEA水平以及VEGF、EGFR阳性表达的结直肠癌患者的血清25-(OH)D水平较低,血清25-(OH)D水平与结直肠癌的发生、发展可能存在密切关联。

Objective To investigate the relationship between serum 25-(OH)D levels and clinical characteristics in patients with colorectal cancer.Methods A total of 234 patients with colorectal cancer were selected.The content of serum 25-(OH)D was detected by enzyme-linked immunosorbent assay(ELISA).The content of serum carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)were measured by electrochemiluminescence,and the expressions of vascular endothelial growth factor(VEGF)and epidermal growth factor receptor(EGFR)in the pathological tissues of colorectal cancer were detected by immunohistochemistry.Results The serum level of 25-(OH)D in patients with colorectal cancer was lower than that in normal healthy people.The serum level of 25-(OH)D in female patients was significantly lower than that in male patients.The serum level of 25(OH)D in patients with right half colon cancer was lower than that in patients with left half colon and rectal cancer.The serum level of 25-(OH)D in patients with tumor invasion depth penetrating the muscular layer was significantly lower than that in patients without penetrating the muscle layer.The serum levels of 25-(OH)D in patients with T4 stage in TNM staging were significantly lower than that in T1,T2 and T3 stages.The serum levels of 25-(OH)D in patients with N1,N2 were lower than N0.The serum levels of 25-(OH)D in patients in stageⅡ,Ⅲ,Ⅳwere lower than that in stageⅠ.The serum level of 25-(OH)D in patients with poorly differentiated and moderately differentiated tumors was lower than that in patients with high differentiated tumors.The serum level of 25-(OH)D in patients with abnormal CEA was lower than that in the normal group.The serum levels of 25-(OH)D in the positive expression group of VEGF and EGFR were lower than that in the negative group(P<0.05).There was no significant statistical difference between age,tumor type,maximum tumor diameter,and CA199 level and serum 25-(OH)D in patients with colorectal cancer(P>0.05).Conclusion The serum level of 25-(OH)D is different in colorectal cancer patients with different genders,tumor location,depth of invasion,lymph node metastasis,degree of differentiation and clinical stage.The serum level of 25-(OH)D is lower in colorectal cancer patients with abnormal CEA level and positive expression of VEGF and EGFR.The serum level of 25-(OH)D may be closely related to the occurrence and development of colorectal cancer.