尿液中的小分子代谢物质检测对胃癌的诊断价值  

Application of Urinary Small Molecular Metabolites in the Diagnosis of Gastric Cancer

作　　者：张东兵[1] 徐露[1] 燕敏[2] 

机构地区：[1]上海瑞金医院集团闵行医院普外科,上海201100 [2]上海交通大学医学院附属瑞金医院外科,上海200025

出　　处：《医学临床研究》2009年第6期966-969,共4页Journal of Clinical Research

摘　　要：【目的】探讨尿液中的小分子代谢物质的检测对胃癌的诊断价值。【方法】选取2005年12月至2006年4月间经胃镜检查与病理活检证实的胃癌患者20例，留取术前与术后第7天清晨第一次排尿的尿样标本，运用气相色谱一质谱联用仪及软件工作站进行色谱质谱分析，同时以47例健康人尿样作为对照组，并与传统血清肿瘤标志物癌胚抗原（CEA），CA72—4，CA199相比较，探讨尿液中小分子代谢物与胃癌临床病理特征的关系。【结果】胃癌患者尿液小分子代谢物质中天冬氨酸、赖氨酸、2-甲基-3-氧-丁酸乙酯三种物质水平显著升高，与正常对照组相比差异有显著性（P〈0．05）；天冬氨酸、赖氨酸、2-甲基-3-氧-丁酸乙酯及其联合测定在胃癌组阳性率（第95百分位数）分别为30％、5％、15％和50％，均高于血清肿瘤标志物及其联合检测的阳性率（0.15％，10％，20％）；手术前2-甲基-3-氧-丁酸乙酯浓度与胃癌肿瘤大小、胃癌肿瘤分期成正相关，（r分别为0．4603和0．6166，均P〈0．05）。【结论】尿液中小分子代谢物质对胃癌诊断具有潜在临床实用价值，有望成为胃癌的新型标志物。[Objective]To evaluate the value of urinary small molecular metabolites in diagnosis of gastric cancer. [Methods]From December 2005 to April 2006, twenty patients with pathologically confirmed gastric cancer were included in this study. Spontaneous urine samples were collected before and 7 days after operation. The small molecular metabolites in the samples were determined by gas chromatographic-mass spectrometric （GC/MS） method. Forty-seven healthy volunteers were also enrolled as control. The routine serum clinical tumor markers, including CEA, CA72 4 and CA19-9 levels of gastric cancer patients were evaluated simultaneously to study the relationship between urinary small molecular metabolites and clinical pathological characteristics of gastric cancer. [Results]The mean level of aspartic acid, lysine and 2-methyl-3-oxo ethylbutyrate among determined urinary small molecular metabolites in gastric cancer group were much higher than those of controls （ P〈0.05）. The positive rates of aspartic acid, lysine, 2-methyl-3-oxo-ethylbutyrate and combination of three metabolites in gastric cancer group were 30%, 5% , 15% and 50%, respectively. These positive rates were higher than those of serum tumor makers in this study. The preoperative level of 2-methyl 3-oxo-ethylbutyrate was positively related with tumor size and the staging of gastric cancer（ P〈0.05）. [Conclusion]Urinary small molecular metabolites may become the promising tumor markers which are feasible in the clinic and will be helpful in the diagnosis of gastric cancer.

关 键 词：胃肿瘤/尿 

分 类 号：R735.2[医药卫生—肿瘤]