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结直肠肿瘤患者血清与组织胃泌素的放免检测

Radioimmunoassay of Serum and Tissue Gastrin in Patients with Colorectal Neoplasia

  • 摘要: 本文连续动态检测了42例结直肠癌、28例结直肠腺瘤患者术前、术后及术后半年以上血清胃泌素(GAS)水平,并对8树结直肠癌标本组织内胃泌素含量进行了检测。结果表明:结直肠癌和结直肠腺瘤患者具有明显的高胃泌素血症(血清GAS水平分别为192.4±103.1Pg/ml,134.95±103.95Pg/ml),明显高于对照组(77.14±39.9Pg/ml)(P<0.01,P<0.05),癌肿或腺瘤切除术后血清GAS水平则下降至接近正常水平,但术后半年以上又分别回升接近其术前水平。癌肿组织内GAS含量(10.74±4.9Pg/g)和癌肿边缘粘膜内含量(8.2±3.6Pg/g)差异无显著性,但两者均显著高于距癌肿5cm处粘膜内含量(4.4±0.8Pg/g)。表明肿瘤分泌GAS是高胃泌素血症的主要机制,GAS检测有助于结直肠肿瘤的诊断、手术效果判断和术后监测,癌肿切除至少应在距癌肿5cm之外,并提出了对结直肠肿瘤患者行抗胃泌素治疗的可行性。关键词

     

    Abstract: Levels of serum gastrin (GAS) were measured in 42 patients with colorectal cancer and 28 patients with colorectal adenoma in radioimmunoassay (RIA), at times of preoperations, postoperatiQns and more than half a year after operations. Extracts from 8cancers and their adjacent tissues and tissues scm from cancers were examined. The results showed: hypergastrineamia was found in patients with coloretal neoplasia. Serum gastrin levels in the cancer group (192. 41 103. IPg/ml) were higher than those in the adenoma group (134. 95 1 103. 95 Pg/ml,PMO. 05),and much higher than those in the control group (77. 14I39. gpg/ml,P0' 01), and levels in adenoma group were higher than those in control group either (P0. 05). After excision of cancers and adenomas,the levels of serum gastrin were reduced nearly to the levels of control group, but re-elevated nearly to their preoperative levesl after more than half a year. Gastrin contents in cancers (10. 7 1 4. gpg/g) were significantly higher than those in tissues scm far from cancers (4. 4f0. SPg/g), but were not different from those in the adjacent tissues (8. 2± 3. 6Pg/g). This suggests that the expressions of gastrin were enhanced in tumor cells and this may be the exact cause of hypergastrineamia. Serum gastrin monitoring may have benificial diagnostic and prognostic values in patients with colorectal neoplasia, and tumor excisions must be made more than scm far from masses. The author also discussed the possible application of anti--gastrin therepy in patients with colorectal neoplasia.

     

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