胃癌根治术前后患者外周血Big内皮素1水平检测的临床意义  

Peripheral plasma Big endothelin 1 levels in patients with gastric carcinoma undergoing radical gastrectomy and its relationship with tumor recurrence

作　　者：滕小军[1] 沈志祥[1] 向进见[2] 沈磊[1] 袁林[2] 郭洁[1] 王晓玲[1] 

机构地区：[1]武汉大学人民医院消化内科,430060 [2]武汉大学人民医院普通外科,430060

出　　处：《中华胃肠外科杂志》2006年第1期34-37,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨胃癌患者手术前后外周血Big内皮素(endothelin,ET)1水平变化的临床意义及其与胃癌复发的关系。方法应用ELASA法检测106例胃癌手术前后患者及20例健康对照者的血浆BigET-1水平。并对进展期胃癌患者术后进行5-30个月随访,期间每3个月复查1次血浆BigET-1直至复发,比较患者手术后与复发前的BigET-1水平。结果106例胃癌患者中,有淋巴结转移及癌浸润突破浆膜者的血浆BigET-1水平均高于无淋巴结转移及未突破浆膜者(P<0.05),差异有统计学意义。进展期(Ⅱ、Ⅲ、Ⅳ期)胃癌患者的血浆BigET-1水平均显著高于正常对照组及早期胃癌(Ⅰ期)者(P<0.01,P<0.05),早期胃癌与对照组间差异无统计学意义。各期患者的血浆BigET-1水平在胃癌手术后第1天均显著升高,第3天下降至术前水平。术后第10天,在Ⅰ、Ⅱ期患者,BigET-1水平与术前相比显著下降(P=0.010,P=0.000),Ⅲ、Ⅳ期患者的BigET-1水平无显著性变化。在随访期间,41例Ⅱ期患者中14例复发,其复发前最后1次的平均BigET-1水平与手术后第10天相比显著升高(P=0.011)。结论胃癌根治术前后血浆BigET-1水平的变化可作为一个判定肿瘤恶性程度的指标。监测胃癌根治术后Ⅱ期患者血浆BigET-1水平对于其复发具有预警作用。Objective To investigate the plasma Big endothelin-1 levels in patients with gastric carcinoma before and after radical gastrectomy, and explore its clinical significance. Methods One hundred and six patients with gastric carcinoma and 20 controls were enrolled. The Big ET-1 plasma levels were examined by enzyme-linked immuno absorbent assay before and on the 1st, 3rd, and 10th day after curative surgery, and then were tested every 3 months in the patients with advanced gastric cancer. Results All patients, except those with stage I gastric cancer, had significantly higher mean plasma Big ET-1 levels compared with normal controls （ P = 0. 000） . Higher plasma Big ET-1 levels were associated with lymph node metastasis （ P = 0. 020） and serosal infiltration （ P = 0. 035）. The plasma Big Endothelin-11eveLs were markedly increased on the first post-operative day （1st POD） in all patients, but decreased on the 3rd POD with no significant difference compared to the preoperative levels. On the 10th POD, the patients with stage I and lI gastric cancer showed marked reduction in plasma Big ET-1 levels （P = 0. 010 and P =0.000, respectively）, whereas no significant difference was observed in stage 111 and IV patients. During the follow-up, the plasma Big ET-1 levels just before recurrence in stage lI patients were significantly higher compared with the levels on the 10th POD （P = 0.011） . Conclusions Plasma Big ET-1 might be a reliable marker to determine the severity of gastric carcinoma. Monitoring plasma Big ET-1 levels after curative resection in stage lI gastric cancer patients is valuable to predict recurrence.

关 键 词：胃肿瘤 胃切除术 根治性 内皮缩血管肽1 复发 

分 类 号：R735.2[医药卫生—肿瘤] R654.2[医药卫生—临床医学]