胃癌患者血漿、胃液和胃腸粘膜中胃動(dòng)素含量的研究

1、胃癌患者血漿、胃液和胃腸粘膜中胃動(dòng)素含量的研究摘要：目的探討胃動(dòng)素與胃癌的關(guān)系，了解胃動(dòng)素的臨床意義。方法應(yīng)用放射免疫法測(cè)定17例胃癌患者和20例正常人血漿、胃液和胃腸粘膜(十二指腸降部、幽門前區(qū)和癌變處)中胃動(dòng)素的含量。結(jié)果胃癌患者血漿和胃液中胃動(dòng)素水平大幅度增高，胃液中胃動(dòng)素含量是血液中的1530倍。結(jié)論胃動(dòng)素與胃癌的發(fā)生和發(fā)展有關(guān)，胃液中高水平的胃動(dòng)素可作為胃癌的輔助指標(biāo)。關(guān)鍵詞：胃癌；胃動(dòng)素；放射免疫法 Study on the Contents of Motilin in Plasma,Gastric Juice andGastroduodenal Mucosa in Patient

2、s with Gastric CancerWANG Ju-changSHI Hong-zhenNanjing first hospital affiliated to Nan Jing medical university,Nan jing 210006Abstract:Objective To investigate the possible relationship between Motilin (MTL) and gastric cancer (GC).Methods MTL contents in plasma,gastric juice and gastroduodenal muc

3、osa including duodenum descendens,pre-pylorus and lesion from 17 cases of GC and 20 normal controls have been measured by radioimmunoassay (RIA). Reaults MTL levels in plasma and gastric juice in GC group were significantly higher than those in the normal controls,The MTL contents in gastric juice w

4、as 1530 times as many as that in plasma.Conclusion MTL may play a important role in pathogenesis and development of GC,furthermore high level of MTL in gastric juice could be a useful marker for diagnosis of GC.Key words: Gastric cancer;Motilin;RIA胃腸激素對(duì)細(xì)胞增生、分化及腫瘤細(xì)胞的調(diào)控作用正日益受到人們的重視。我們應(yīng)用放射免疫法對(duì)正常人和胃癌患者的

5、血漿、胃液及胃腸粘膜進(jìn)行檢測(cè)，觀察其與胃癌發(fā)生和發(fā)展的關(guān)系。1材料與方法1.1研究對(duì)象胃癌組17例，男11例、女6例，平均年齡468.2歲，均經(jīng)胃鏡、病理檢查證實(shí)，其中腺癌9例、粘液癌6例、印戒細(xì)胞癌2例。正常對(duì)照組20例，男15例、女5例，平均年齡384.5歲，均無(wú)消化系疾病，胃鏡檢查結(jié)果顯示胃十二指腸粘膜正?；虼笾抡?。Hp尿素酶實(shí)驗(yàn)及病理檢測(cè)均陰性。1.2方法標(biāo)本處理方法：所有受試者三天內(nèi)停用一切影響胃腸運(yùn)動(dòng)及分泌的藥物，檢查當(dāng)日晨抽取空腹靜脈血2ml，再行胃鏡檢查，先抽取胃液5ml，然后于十二指腸降部、幽門前區(qū)及病變處等部位各取粘膜一塊，立即置于-70C，血液和胃液分別置于含肝素和抑肽

6、酶的試管中，即刻分離血漿-20C凍存。粘膜處理：將活檢粘膜移至微型玻璃勻漿器中，加0.3ml 0.1mol/L HAC，于冰浴中充分勻漿后，100C水浴煮沸5分鐘，再加等量0.1mol/L NaOH中和，4C 12000r/min離心10分鐘，取上清液，-20C凍存。放射免疫分析法：胃動(dòng)素藥盒為解放軍東亞免疫技術(shù)研究所提供，蛋白定量用Lowry法。統(tǒng)計(jì)處理用t檢驗(yàn)。2結(jié)果胃癌患者血漿、胃液及粘膜中胃動(dòng)素含量見表1和表2。表1血漿和胃液中胃動(dòng)素含量(s ng/l)血漿胃液胃癌組(n=17)75.649.72623.73406.6#對(duì)照組(n=20)49.116.8678.3423.2注：與對(duì)照組

7、比P0.05#P0.05表2粘膜中胃動(dòng)素含量(s nmol/g蛋白質(zhì))十二指腸降部病變處幽門前區(qū)胃癌組(n=17)2.050.670.450.291.020.29對(duì)照組(n=20)2.430.630.850.243討論胃動(dòng)素是一種主要由消化道粘膜MO細(xì)胞分泌的多肽激素，與胃腸運(yùn)動(dòng)密切相關(guān)。有人研究約80%胃癌和大腸癌組織中存在胃動(dòng)素陽(yáng)性細(xì)胞1，提示胃動(dòng)素與胃腸道腫瘤發(fā)生發(fā)展的某些環(huán)節(jié)有關(guān)。本文檢測(cè)結(jié)果表明，胃癌患者血液和胃液中胃動(dòng)素水平均大幅度增高，并且胃液中濃度明顯高于血漿濃度，約為血漿濃度的1530倍，高水平的胃動(dòng)素，尤其是胃液中胃動(dòng)素明顯升高，提示胃動(dòng)素可能具有外分泌作用方式，其檢測(cè)結(jié)果可否作為胃癌診斷的輔助指標(biāo)以及胃癌與潰瘍病變的鑒別診斷值得重視。粘膜中胃動(dòng)素含量分析表明，十二指腸降部粘膜胃動(dòng)素含量高于幽門前區(qū)粘膜含量，病變處部位粘膜胃動(dòng)素含量最低，似乎不支持胃癌組織中存在胃動(dòng)素陽(yáng)性細(xì)胞的報(bào)道，亦與胃液中高水平的胃動(dòng)素不相吻合，我們認(rèn)為胃動(dòng)素的分泌可能與癌細(xì)胞的類型、分化程度，產(chǎn)生部位有關(guān)；胃腸道內(nèi)環(huán)境的