胃癌化疗前后血清巨噬细胞抑制因子—1水平的变化及其临床意义

谢艳茹+吴敏华+周月芬

[摘要] 目的 探討进展期胃癌化疗前后血清巨噬细胞抑制因子-1（MIC-1）水平的变化及其临床意义。 方法 回顾性分析2013年1月～2015年1月在丽水市中心医院住院的进展期胃癌患者61例，应用酶联免疫吸附测定双抗体夹心法检测其化疗前、化疗2个周期后血清MIC-1水平，采用电化学发光免疫分析仪检测上述胃癌患者血清标本癌胚抗原（CEA）、糖类抗原（CA199）浓度，分析化疗前后血清肿瘤标志物水平的变化与临床资料的关系。 结果 化疗后MIC-1、CEA、CA199水平均明显低于化疗前，差异均有统计学意义（P < 0.05）。MIC-1水平与临床分期及分化程度相关（P < 0.05）。MIC-1联合CEA、CA199三者作为一个肿瘤标志物，化疗前其表达与临床分期、分化程度及化疗疗效相关（P < 0.05），与腹水高度相关（P < 0.01）；化疗后其表达与腹水、分化程度、化疗效果均相关（P < 0.01）。 结论 MIC-1在诊断进展期胃癌方面有较高的研究价值，同时联合CEA、CA199检测可以更好地评价胃癌患者的化疗效果，对于判定胃癌患者预后及预示复发有一定的预测价值。MIC-1作为一种新的肿瘤标志物具有良好的应用前景及研究价值。

[关键词] 巨噬细胞抑制因子；肿瘤标志物；胃癌；研究价值

[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210（2018）01（b）-0092-05

[Abstract] Objective To investigate the changes and the clinical significance of serum macrophage inhibitory cytokine （MIC-1） levels before and after chemotherapy in advanced gastric cancer. Methods The clinical data of 61 patients with advanced gastric cancer admitted to Lishui Central Hospital from January 2013 to January 2015 were retrospective analyzed. Double antibody sandwich ELISA method was applied to detect the serum MIC-1 levels before chemotherapy and after 2 cycles of chemotherapy. The carcinoembryonic antigen （CEA） and cancer antigen-199 （CA199） concentration in serum samples of the gastric cancer were detected by electrochemiluminescence immunoassay analyzer. Relationship between the levels of serum tumor marker before and after chemotherapy and the clinical data were analyzed. Results After chemotherapy， the levels of MIC-1， CEA and CA199 were all significantly lower than those of before chemotherapy， with statistically significant differences （P < 0.05）. The level of MIC-1 was correlated with the clinical stage and the degree of differentiation， with statistically significant differences （P < 0.05）. MIC-1 combined with CEA and CA199 as one tumor marker， before chemotherapy， the expressions were correlated with the clinical stage， the degree of differentiation and the chemotherapy efficacy （P < 0.05）， and was highly correlated with ascites （P < 0.01）. After chemotherapy， the expressions were highly correlated with ascites， differentiation and chemotherapy efficacy （P < 0.01）. Conclusion This study suggests that MIC-1 has high research value in the diagnosis of advanced gastric cancer. MIC-1 combine with CEA and CA199 can better evaluate the chemotherapy efficacy in patients with gastric cancer and has certain prognostic value for determining the prognosis and the occurrence. As a new tumor marker， MIC-1 has good application prospect and research value.endprint

[Key words] Macrophage inhibitory factor； Tumor marker； Gastric cancer； Research value

中国每年都有较其他国家更多的新发胃癌病例，在我国其发病率和死亡率均升至恶性肿瘤的第三位。自2005年以来，丽水地区胃癌发病率一直高居首位，严重危害人们健康[1]。胃癌在临床诊治过程中，肿瘤标志物检测已经广泛开展，目前临床常用的肿瘤标志物主要是癌胚抗原（CEA）、糖类抗原199（CA199）等，但缺乏较高的特异性及灵敏度，且不能作为生化复发及疗效评定指标。目前越来越多的实验采用新的或几种肿瘤标志物联合检测，进而提高胃癌的诊断效能，更好地进行疗效判定及预后评价。近年大量研究发现，巨噬细胞抑制因子-1（MIC-1）作为人转化生长因子β（TGF-β）家族成员，广泛参与细胞凋亡、侵袭和转移[2]。正常血清中，MIC-1表达水平低下，而在恶性肿瘤、炎症等病理情况下MIC-1表达水平可明显升高，且持续时间显著延长[3]。……