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目的 研究可溶性肿瘤坏死因子受体I(solubletumornecrosisfactorreceptor ,sTNFR I)在头颈部肿瘤患者中的表达及临床意义。方法 采用酶联免疫吸附法 (enzymelinkedimmunosorbentassay,ELISA) ,检测南京医科大学第一附属医院 1997年 2月～ 2 0 0 0年 4月 16 0例头颈部恶性肿瘤患者 (其中恶性淋巴瘤 12例 ,鼻咽癌 6 2例 ,喉癌 5 6例 ,下咽癌 2 2例 ,上颌窦癌 3例 ,甲状腺瘤癌 5例 )血清sTNFR I的水平 (IU/ml, x±s)。结果 患者血清中sTNFR I含量 (138 4 6± 39 9)显著高于健康对照组(47 2± 2 0 7,n =5 8) ,差异有显著性 (P <0 0 1)。在头颈部各种恶性肿瘤患者中 ,鼻咽癌和恶性淋巴瘤患者的sTNFR I水平为最高 (分别为 16 2 2± 39 2和 189 4± 5 2 4 )。此外 ,sTNFR I与肿瘤的临床分期及外周血白细胞数、部分酶谱、尿素氮、肌酐呈正相关 ,而与白蛋白、血小板呈负相关 ,其中鼻咽癌、恶性淋巴瘤与VCA IgA呈显著正相关。结论 检测头颈部恶性肿瘤患者血清sTNFR I,不但可在一定程度上用于了解患者的免疫状态 ,而且也能在一定程度上有助于对疾病的严重程度、肿瘤分期、疗效及预后等作出评估。
Objective To study the expression and clinical significance of soluble tumor necrosis factor receptor I (sTNFR I) in patients with head and neck cancer. Methods A total of 160 patients with head and neck malignant tumors (including 12 cases of malignant lymphoma, (2 cases of nasopharyngeal carcinoma, 5 cases of laryngeal carcinoma, 2 cases of hypopharyngeal carcinoma, 3 cases of maxillary sinus cancer, 5 cases of thyroid carcinoma) serum levels of sTNFR I (IU / ml, x ± s). Results The serum level of sTNFR I in the patients was significantly higher than that in the healthy controls (138 4 6 ± 39 9) (47 2 ± 2 0 7, n = 58) (P 0 01). Among various malignant tumors of the head and neck, patients with NPC and malignant lymphoma had the highest sTNFR I levels (16 2 2 ± 39 2 and 189 4 ± 5 2 4, respectively). In addition, sTNFR I was positively correlated with clinical stage, peripheral blood leukocyte count, partial zymogram, urea nitrogen and creatinine, but negatively correlated with albumin and platelet, and nasopharyngeal carcinoma, malignant lymphoma and VCA IgA were significantly positive Related. Conclusion The detection of serum sTNFR I in patients with head and neck malignant tumor can not only be used to understand the patient’s immune status to a certain extent, but also help to some extent to the severity of the disease, tumor staging, efficacy and prognosis Evaluation.