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目的:探讨血清急性时相蛋白变化在评估胃癌患者预后及术后复发早期诊断中的价值。方法:全自动速率散射比浊法检测120名胃癌患者手术前、后血清急性时相蛋白的水平;胃癌根治术87名患者,术后每3个月随访一次,且检测血清急性时相蛋白水平,现察其复发情况,至少随防18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及良性胃病组(P<0.001),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>0.05);胃癌术后一定时期血清CRP、α1-AT和α-AG水平显著低于术前水平(P<0.01或P<0.05),其它指标差异无显著性(P>0.05)。复发组30例,其血清CRP、α1-AT和α-AG水平一定时期后逐渐升高;无复发组57例,其血清CRP/α1-AT和α-AG水平则维持在相对恒定的正常水平,手术前后差异有显著性(P<0.01)。联合检测CRP、α1-AT和α-AG,对复发肿瘤诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值分别达到90.91％、83.33％、90.48％、90.48％和83.33％。结论:联合检测急性时相蛋白可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 assessing the prognosis of patients with gastric cancer and the early diagnosis of postoperative recurrence. Methods: The serum level of acute phase protein in 120 gastric cancer patients before and after surgery was detected by automatic rate nephelometry. 87 patients underwent radical gastrectomy were followed up every 3 months after operation. The serum acute phase protein level , The recurrence is observed, at least with the anti-18 months or to death. Results: Serum C-reactive protein (CRP), α1-antitrypsin (α1-AT) and α-AG were significantly higher in gastric cancer group than those in healthy control group and benign gastric group (P <0.001) There was no significant difference in the levels of ceruloplasmin, transferrin (TFR) and prealbumin (PAB) between the two groups (P> 0.05). Serum levels of CRP, α1-AT and α-AG were significantly lower Preoperative level (P <0.01 or P <0.05), other indicators no significant difference (P> 0.05). The CRP, α1-AT and α-AG levels increased gradually after a certain period in relapse group. The serum CRP / α1-AT and α-AG levels were maintained at a relatively constant level in 57 patients without recurrence There was significant difference before and after operation (P <0.01). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CRP, α1-AT and α-AG in diagnosis of recurrent tumors were 90.91%, 83.33%, 90.48%, 90.48% and 83.33% respectively. Conclusion: The combined detection of acute phase protein can assess the prognosis of patients with gastric cancer, which can provide reliable clinical information for the early diagnosis of gastric cancer recurrence.