肝癌患者血清sTNFR　Ⅰ的临床意义  

THE CLINICAL SIGNIFICANCE OF ELEVATED SERUM SOLUBLE TUMOR NECROSIS FACTOR RECEPTOR I IN HEPATOMA PATIENTS

作　　者：王裕发[1] 巫协宁[1] 吴晴[1] 张晓琼[1] 陈霞芳[1] 周小寒[1] 温文倩[1] 陈美玉[1] 

机构地区：[1]上海市第一人民医院

出　　处：《上海医学》1996年第12期694-696,共3页Shanghai Medical Journal

摘　　要：为评估可溶性肿瘤坏死因子受体（ｓＴＮＦＲ）在肝癌中的作用和临床意义，我们用ＥＬＩＳＡ方法检测了８３例肝癌患者和６１例健康人的血清ｓＴＮＦＲＩ水平变化。结果发现肝癌患者血清ｓＴＮＦＲＩ的平均水平明显高于健康对照组（２．６２±０．７９ｎｇ／ｍｌ对０．９３±０．２９ｎｇ／ｍｌ，Ｐ＜０．００１）。升高幅度与疾病分期明显相关，即Ⅲ～Ⅳ期患者的水平明显高于Ⅰ～Ⅱ期患者（２．９７±０．４３ｎｇ／ｍｌ对１．７４±０．４１ｎｇ／ｍｌ，Ｐ＜０．００１）。同时我们发现ｓＴＮＦＲⅠ升高与血清碱性磷酸酶（ｒ＝０．５９）、白细胞计数（ｒ＝０．４３）、血清球蛋白（ｒ＝０．３２）成正相关，而与血清白蛋白（ｒ＝－０．７１）成负相关。在肝癌患者中，血清ｓＴＮＦＲⅠ升高率（８９．１６％）远大于血清ＡＦＰ阳性率（５４．２２％）。２５例化疗患者，ｓＴＮＦＲⅠ升高者显示缺乏临床效应，而降低者则有缓解（３．３９±０．４３ｎｇ／ｍｌ对２．６７±０．３４ｎｇ／ｍｌ，Ｐ＜０．００１）。实验结果显示：肿瘤患者血清ｓＴＮＦＲⅠ水平与疾病的分期和对化疗的反应相关，它的测定对肿瘤的检测、随访和预后的评估有辅助诊断意义，表明ｓＴＮＦＲⅠ可作为宿主对肿瘤的生物学反应的标?n order to elucidate the biological functions and clinical significance of soluble TNF re-ceptor(sTNF R) in hepatoma patients, we observed the changes of serun sTNF R I levels in83 hepatoma patients and in 61 healthy controls by sandwich enzyme immunoassay,Themean serum sTNF I Ievels were significantly increased in hepatoma patients than those incontrols (2.62±0.79ng/ml versus 0.93±0.29ng/ml,P<0.001).The increment correlatedwell with staging of disease,i.e.,patients with stages Ⅲ～Ⅳ>those with stages Ⅰ～Ⅱ(2.97±0.43ng/ml vs 1.74±0.41ng/ml, P<0.001).Also,we found the increase of sTNFRI level correlated positively with serum alkaline phosphatase(r=0.59),the white bloodcell count(r=0.43),serum globulin(r=0.32)and correlated negatively with serum albu-min(r=0.71).Among the hepatoma patients,the frequency of increase in the serum solubleTNF R I level(89.16%)greatly exceeded that of serum AFP,(54.22%).Moreover,in 25patients before and after chemotherapy,the rise of sTNFR I showed lack of clinical re-sponse(3.39±0.43ng/ml vs 2.67±0.34ng/ml,P<0.001).These results suggest that theserum sTNFR I level in cancer patients correlate well with staging of the disease and re-sponse to chemotherapy,its determination can serve as a diagnostic aid in the detection ofcancer,as well as in follow-up study,and in assessment of its prognosis.In conclusion,thesTNFR might serve as a marker of host biological response in cancer patients,the signifi-cance of which needs further investigation.

关 键 词：肝癌 肝瘤坏死因子 病理学 

分 类 号：R735.702[医药卫生—肿瘤]