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目的 探讨血清急性时相蛋白在胃癌患者根治术后复发早期诊断中的价值。方法 检测1 2 0例胃癌患者 (胃癌根治 87例 ,胃癌姑息切除 33例。)手术前、后血清急性时相蛋白的水平并与健康对照组对照。对胃癌根治术的 87名患者 ,分别于术后 1 ,3 ,6 ,9,1 2个月检测血清急性时相蛋白水平 ,每 3个月随访 1次 ,观察其复发情况 ,至少随访 1 2个月或至死亡。结果 胃癌组血清C -反应蛋白(CRP)、α1 -抗胰蛋白酶 (α1 AT)和α -酸性糖蛋白 (α AG)水平显著高于健康对照组 (P <0 .0 1 ) ,铜蓝蛋白 (CER)、转铁蛋白 (TFR)和前白蛋白 (PAB)水平差异无显著性 (P >0 .0 5) ;胃癌根治组术后一定时期血清CRP ,α1 AT和α AG水平显著低于术前水平 ,其他指标无显著改变。根治组术后复发者血清CRP ,α1 AT和α AG水平手术前、后均显著高于未复发组 (P <0 .0 1 )。CRP ,α1 AT和α AG阳性组复发率 (60 % ,63 .3 % ,46 .1 5 % )显著高于阴性组 (1 4 .2 8% ,1 3 .1 6 % ,1 4 .85 % )。结论 检测急性时相蛋白有助于评估胃癌患者的预后 ,能为胃癌术后复发的早期诊断提供可靠的临床信息
Objective To investigate the value of serum acute phase protein in the early diagnosis of gastric cancer recurrence after radical surgery. Methods One hundred and twenty cases of gastric cancer (87 cases of radical gastrectomy and 33 cases of palliative resection of gastric cancer) were detected before and after surgery, and the levels of acute phase protein in serum were compared with those of the healthy control group. Eighty-seven patients with radical gastrectomy were tested for acute phase protein levels at 1, 3, 6, 9 and 12 months after operation, followed up every 3 months to observe the relapse rate. At least 12 Months or until death. Results The levels of serum C - reactive protein (CRP), α1 - antitrypsin (α1 AT) and α - acid glycoprotein (α AG) in gastric cancer group were significantly higher than those in healthy controls (P <0.01) (P> 0.05). There was no significant difference in serum levels of CER, TFR and PAB between the two groups (P> 0.05). The levels of serum CRP, α1 AT and α AG in the radical group were significantly lower than those in the radical group Preoperative level, other indicators no significant change. The levels of CRP, α1 AT and α AG in the radical group were significantly higher than those in the non-recurrence group (P <0.01) before and after the operation. The recurrence rates (60%, 63.3%, 46.1 5%) of CRP, α1 AT and α AG positive group were significantly higher than those of negative group (14.28%, 13.1%, 14.55% %). Conclusion Detection of acute phase protein is helpful to evaluate the prognosis of patients with gastric cancer and provide reliable clinical information for the early diagnosis of postoperative recurrence of gastric cancer