恶性肿瘤患者血浆和胸腹水可溶性Apo-1/Fas的检测及其临床意义

Detection of soluble Apo-1/Fas in plasma,pleural and ascites fluid of malignant tumor patients and its clinical significance

目的 :研究恶性肿瘤患者血浆和胸腹水可溶性 Apo- 1/ Fas水平变化及其临床意义。方法 :用 EL ISA法检测 15 7例恶性肿瘤患者和 2 5例正常对照组血浆以及 12 9例不同性质胸腹水可溶性 Apo- 1/ Fas浓度变化。结果 :恶性血液病中急性白血病、慢性白血病和多发性骨髓瘤 (MM)患者血浆可溶性 Apo- 1/ Fas水平均显著高于正常对照组 (P<0 .0 5 ) ;慢性粒细胞白血病高于急性粒细胞白血病 ,慢性淋巴细胞白血病高于急性淋巴细胞白血病 (P<0 .0 5 ) ;急性白血病和 MM化疗完全缓解时 Apo- 1/ Fas水平显著下降 (P<0 .0 5 ) ,无效和复发病例均为高值。在实体恶性肿瘤中血浆可溶性 Apo- 1/ Fas水平也均显著高于正常对照组 (P<0 .0 1) ,且转移性癌显著高于非转移癌 (P<0 .0 1) ,术后好转或放疗后缓解患者较术前或放疗前明显回落 (P<0 .0 1) ,而术后复发转移患者显著升高 (P<0 .0 1)。恶性肿瘤患者胸腹水可溶性 Apo- 1/ Fas水平明显增高 ,并明显高于结核性和漏出性胸腹水 (P<0 .0 1)。结论 :恶性肿瘤患者血浆和胸腹水可溶性 Apo- 1/ Fas水平明显升高 ,并可能与肿瘤的发生、发展有关 ,观察其水平变化 ,有助于了解肿瘤的病理过程 ,鉴别胸腹水的不同性质。

Objective: To study the changes of soluble Apo-1/Fas levels in plasma,pleural and ascites fluid of malignant tumor patients and to evaluate their clinical significance. Methods: The soluble Apo-1/Fas levels were measured by enzyme-linked immunosorbent assay(ELISA) in the plasma of 157 malignant tumor patients and 25 normal controls as well as in the pleural and ascite fluids of 129 patients with various diseases. Results: The plasma soluble Apo-1/Fas levels in acute and chronic leukemia and multiple myeloma were significantly higher than those in normal controls(P<0.05). The plasma soluble Apo-1/Fas levels in chronic myeloid leukemia and chronic lymphocytic leukemia were significantly higher than those in acute myeloid leukemia and acute lymphocytic leukemia,respectively(P<0.05). After chemotherapy,the plasma soluble Apo-1/Fas levels in complete remission group were distinctly decreased(P<0.05),whereas the levels in no remission and recurrence groups remained high. Compared with normal controls,the plasma soluble Apo-1/Fas levels in solid tumors were significantly increased(P<0.01),and the levels in metastasis cancers were significantly higher than those in non-metastasis cancers(P<0.01). Simultaneously the levels in remission cancer patients after operation and radiotherapy were distinctly lower than those before treatment(P<0.01),but were significantly increased in recurrence cancer patients(P<0.01). The soluble Apo-1/Fas levels in pleural and ascites fluid of malignant tumors were significantly higher than those in tuberculous effusions and transudates. Conclusion: The soluble Apo-1/Fas levels in plasma,pleural and ascites fluid of malignant tumor patients are markedly increased,which might be associated with the progress of cancers. The changes of soluble Apo-1/Fas levels may be useful for understanding the pathologic process of cancers and to differential diagnosis of various pleural and ascites fluids.