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目的 研究胃癌患者血清及组织中可溶性白细胞介素 2受体 (sIL 2R)变化的临床意义。方法 采用双抗体夹心ELISA法 ,对 5 8例胃癌患者手术前后、32例胃良性疾病患者 (慢性浅表性胃窦炎患者 2 6例 ,功能性消化不良 6例 )及 36例健康体检者血清sIL 2R水平进行检测 ;同时检测了胃癌及胃良性疾病者活检组织中sIL 2R的浓度。结果 胃癌患者血清sIL 2R(U /L)为 911± 179,明显高于胃良性疾病者 (30 3± 2 0 )和健康体检者 (30 1± 15 ) ,P <0 .0 0 1。胃癌组织中sIL 2R为 934± 197明显高于胃良性疾病胃粘膜组织 (311± 2 0 ) ,P <0 .0 0 1。胃癌按Ⅰ～Ⅳ级分期的不同 ,sIL 2R在血清和组织中逐渐增高 ,且各期之间进行比较均P <0 .0 0 1;其中Ⅰ期 (11例 )、Ⅱ期 (10例 )、Ⅲ期 (2 2例 )术后血清sIL 2R明显下降 (各自P <0 .0 0 1) ;而Ⅳ期患者 (15例 )手术前后无明显变化且有所增高 ;手术切除组 (46例 ,根治或姑息手术 )术后sIL 2R明显降低 (P <0 .0 0 1) ,而探查者或胃空肠吻合术者 (12例 ) ,术后血清sIL 2R反而增高。结论 动态观察血清及组织sIL 2R的变化可作为胃癌的诊断、手术方法的选择、疗效评价及预后监测有意义的参考指标。
Objective To study the clinical significance of soluble interleukin 2 receptor (sIL 2R) changes in serum and tissues of gastric cancer patients. METHODS: Double antibody sandwich ELISA was used to evaluate the preoperative and postoperative outcomes of 58 patients with gastric cancer, 32 patients with benign gastric disease (26 patients with chronic superficial antral gastritis, 6 patients with functional dyspepsia) and 36 healthy volunteers. The level of sIL 2R was measured; the concentration of sIL 2R in biopsies of gastric cancer and benign gastric disease was also measured. Results The serum sIL 2R (U/L) in patients with gastric cancer was 911±179, which was significantly higher than that in patients with benign gastric disease (30 3±20) and healthy subjects (30 1±15), P <0.01. The sIL 2R in gastric cancer tissues was 934± 197, which was significantly higher than that in gastric benign diseases (311±20), P <0.01. According to the stage I to IV of gastric cancer, sIL 2R was gradually increased in serum and tissues, and the comparison between each stage was P 0. 01; of which stage I (11 cases), II (10 cases) Serum sIL 2R levels were significantly decreased in stage III (22 cases) (P < 0.01), while stage IV (15 cases) had no significant changes before and after surgery and increased; surgical resection group (46 cases) sIL 2R decreased significantly after radical or palliative surgery (P < 0.01). However, postoperative sIL 2R increased in patients who underwent gastrojejunostomy or gastrojejunostomy (12 cases). Conclusion Dynamic observation of changes in serum and tissue sIL 2R may serve as a useful reference marker for the diagnosis of gastric cancer, selection of surgical methods, efficacy evaluation, and prognostic monitoring.