作　　者： (何磊）; (黄芬）; (叶冬青）; (程元光）; (文刚）;

机构地区： 安徽医科大学第三附属医院,合肥230061

出　　处： 《山东医药》 2017年第29期20-22,共3页

摘　　要： 目的探讨结直肠癌患者门静脉血前列环素I_2(PGI_2)和血栓素A_2(TXA_2)的水平变化及意义。方法60例结直肠癌患者,同时性肝转移22例(肝转移组),无肝转移38例(无肝转移组),肿瘤最大长径≤3.0 cm、3.1~4.0 cm、>4.0 cm分别为15、24、21例。对照为16例粘连性肠梗阻患者正常结直肠黏膜组织(对照组)。采用放射免疫法检测患者门静脉血和癌组织、正常结直肠黏膜组织PGI_2和TXA_2水平,并进行比较。结果与正常结直肠黏膜组织比较,结直肠癌组织中TXA_2水平高,PGI_2水平低(P<0.01)。与对照组比较,肝转移及无肝转移组门静脉血PGI_2、PGI_2/TXA_2降低,TXA_2升高(P均<0.01);与无肝转移组比较,肝转移组门静脉血PGI_2、PGI_2/TXA_2降低,TXA_2升高(P均<0.01)。与肿瘤最大长径≤3.0 cm、3.1~4.0 cm比较,>4.0 cm患者PGI_2及PGI_2/TXA_2降低,TXA_2升高(P均<0.05)。门静脉血PGI_2/TXA_2与肿瘤大小呈负相关(r=-0.770),结直肠癌伴同时性肝转移者门静脉血PGI_2/TXA_2低于无肝转移者(P<0.01)。结论结直肠癌患者门静脉血TXA_2水平升高和PGI_2/TXA_2降低,门静脉血PGI_2/TXA_2下降可能是促进结直肠癌肝转移的重要原因之一。 Objective To investigate the changes in levels of portal venous blood prostacyclin I_2（ PGI_2） and thromboxane A_2（ TXA_2） in patients with colorectal carcinoma and their clinical significance. Methods Sixty patients with colorectal carcinoma were selected in the study,including 22 cases with synchronous liver metastasis（ liver metastasis group）,38 cases without liver metastasis（ non-liver metastasis group）,20 cases in stageⅡof p TNM staging,32 cases in stage Ⅲ,and 8 cases in stage Ⅳ.Meanwhile,16 cases of postoperative adhesive intestinal obstruction were considered as controls（ control group）. The levels of PGI_2 and TXA_2in the portal venous blood,tumor tissues,and normal colorectal mucosae were detected by radioimmunoassay,respectively,and then were compared with those of the controls. Results Compared with the normal colorectal mucosae,the level of TXA_2 increased,while the level of PGI_2 decreased significantly in the colorectal cancer tissues（ both P 0. 01）; compared with the control group,the level of PGI_2 increased,and the ratio of PGI_2/TXA_2 and TXA_2decreased significantly in the non-liver metastasis group and liver metastasis group（ all P 0. 01）. Compared with the non-liver metastasis group,the level of portal venous blood PGI_2 and the ratio of PGI_2/TXA_2 decreased,TXA_2increased in the liver metastasis group（ all P 0. 01）. Compared with patients whose tumor maximum diameter ≤3. 0 cm,3. 1 cm-4. 0 cm,the level of PGI_2 and the ratio of PGI_2/TXA_2 decreased,TXA_2increased in patients with tumor diameter 4. 0 cm（ all P 0. 05）. The ratio of PGI_2/TXA_2 value of portal vein was negatively correlated with the size of the tumor（ r =-0. 770）. The ratio of PGI_2/TXA_2 in portal vein blood of patients with colorectal cancer and synchronous liver metastasis was lower than that without metastasis（ P 0. 01）. Conclusions The level of TXA_2 increases and the ratio of PGI_2/TXA_2 decreases in the portal vein blood of patients with colorectal cancer. The decrease

关 键 词： 结直肠肿瘤 前列环素 血栓素 门静脉