癌症患者血浆和组织浸液凝血酶调节蛋白的检测及临床意义

Detection of thrombomodulin in both plasma and tissue extracts of cancer patients and its clinical significance

目的 :研究癌症患者血浆和组织浸液凝血酶调节蛋白 (TM)的浓度变化及其意义。方法 :用 ELISA法检测 188例癌症患者血浆 TM和 2 4例癌组织及其邻近正常组织浸液的 TM浓度。结果 :癌症患者血浆 TM水平[(33.4 7± 14 .2 5 ) μg/ L]明显高于对照组 [(2 0 .4 0± 7.2 2 ) μg/ L,P<0 .0 1],癌症转移组 [(4 1.6 8± 16 .96 ) μg/ L]明显高于对照组 (P<0 .0 1) ,术后组患者 TM[(18.4 5± 9.96 ) μg/ L]比术前组 TM[(2 8.2 9± 11.74 ) μg/ L]明显回落 (P<0 .0 1) ,术后复发转移组 TM水平 [(34.5 0± 12 .5 7) μg/ L]明显增加。肺癌、胃癌和胰腺癌三种转移性癌均明显高于各自的非转移性癌 (P<0 .0 5～ 0 .0 1) ,而非转移的胃癌、胰腺癌、食道癌、大肠癌和喉癌与对照组比较均无明显差异(P>0 .0 5 )。癌组织浸液 TM[(6 47.71± 317.5 1) μg/ L]显著低于其邻近正常组织 [(14 5 5 .6 3± 772 .2 2 ) μg/ L,P<0 .0 1],而其血浆 TM则明显高于对照组。结论 :癌症患者血浆 TM水平升高与癌的扩散转移有关 ,其水平可作为判断病情进展和转移的一个敏感指标。

Objective: To study the changes of thrombomodulin(TM) in both plasma and tissue extracts of cancer patients for evaluating its clinical significance. Methods: Plasma TM levels were measured by enzyme linked immunosorbent assay(ELISA) in plasma of 188 cancer patients and in 24 cancer tissue extracts including their adjacent normal tissue. Results: The plasma TM levels both in cancer patients and in metastasis patients were significantly higher than that in controls [(33.47±14.25)μg/L/(41.68 ±16.96)μg/L, vs (20.40±7.22)μg/L, P < 0.01 ]. The plasma TM levels in cancer patients after operation decreased obviously [(18.45±9.96)μg/L, vs ( 28.29 ±11.74)μg/L, P <0.01]. Whereas, the plasma TM levels in patients with recurrence and metastasis after operation increased obviously[(34.50±12.57)μg/L]. The plasma TM levels in metastatsis of lung cancers, gastric cancers and pancreatic cancers were significantly higher than that in non metastasis ( P <0.05～0.01) respectively, but no significant differences were found between controls and non metastasis cancers including gastric cancers, pancreatic cancers, nasopharyngeal cancers, large intestine cancers and laryngeal cancers( P >0.05).The TM levels in cancer tissue extracts were significantly lower than that in their adjacent normal tissue extracts[(647.71±317.51)μg/L, vs (1455.63±772.22)μg/L, P <0.01].On the contrary, the plasma TM levels in these cancers were higher than that in controls. Conclusion: The rise of plasma TM levels in cancer patients is associated with metastasis and diffusion of cancers. The TM levels can be used as an sensitive index for judging progression and metastasis of cancers.[