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目的 探讨透明质酸 (HA)、Ⅳ型胶原 (ColⅣ )在大肠癌患者血清中含量和ColⅣ在组织内的表达及其临床意义。方法 采用放射免疫法测定大肠癌 (n =6 0 )和健康人 (n =2 0 )血清中HA、ColⅣ含量 ,应用免疫组化法检测了正常大肠粘膜 (n =1 0 )和大肠癌 (n =6 0 )及癌旁组织内 (n =6 0 )ColⅣ的表达。结果 大肠癌患者血清HA [( 2 0 2 .6 0± 1 5 9.78)ng ml]、ColⅣ [( 1 2 4.6 4±42 .1 2 ) μg L]含量明显高于正常对照组的HA[( 6 1 .2 0± 1 4.2 0 )ng ml]和ColⅣ [( 5 9.9± 1 4.6 0 ) μg L](P <0 .0 1 )。DukesC、D期血清HA含量明显高于A、B期 (P <0 .0 1 ) ;DukesC、D期血清ColⅣ含量高于A、B期 ,但差异不显著 (P >O .0 5 )。血清HA、ColⅣ含量与肿瘤的分化程度、大小无显著相关性 (P >0 .0 5 ) ,有淋巴结转移组血清HA、ColⅣ含量明显高于无淋巴结转移组 (P <0 .0 1 )。大肠癌患者血清HA、ColⅣ阳性检出率明显高于癌胚抗原 (Carcinoembryonicantigen ,CEA)阳性检出率。血清HA、ColⅣ含量有淋巴结转移组术前术后比较无显著性差异 ;无淋巴结转移组术后HA、ColⅣ水平有下降趋势 ,但无统计学差异 (P >0 .0 5 )。大肠癌组织ColⅣ分布有不同程度的减少 ,与大肠癌Dukes分期呈负相关 ,有转移的大肠癌组织中Co
Objective To investigate the content of serum HA and collagen IV (Col IV) in colorectal cancer patients and the expression of Col IV in tissues and its clinical significance. Methods The levels of HA and Col IV in serum of colorectal cancer (n = 60) and healthy people (n = 20) were measured by radioimmunoassay. Normal colorectal mucosa (n =1 0) and colorectal cancer were detected by immunohistochemistry. n = 6 0 ) and the expression of ColIV in adjacent tissues (n = 60). Results The serum levels of HA [(2 0 2 . 6 0 ± 15 9.78) ng ml] and Col IV [( 1 2 4.6 4 ± 42 .1 2 ) μg L] were significantly higher in patients with colorectal cancer than those in the normal control group [[ 6 1 .2 0 ± 1 4.2 0) ng ml] and ColIV [( 5 9.9 ± 14.6 0) μg L] (P < 0.01). The serum HA levels in Dukes C and D stages were significantly higher than those in stages A and B (P < 0.01). The serum Col IV levels in Dukes C and D stages were higher than those in stages A and B, but the difference was not significant (P > 0.05). There was no significant correlation between serum HA and Col IV levels and tumor differentiation and size (P > 0.05). Serum HA, Col IV levels in lymph node metastasis group were significantly higher than those without lymph node metastasis (P < 0.01). The positive rate of serum HA and ColIV in patients with colorectal cancer was significantly higher than that of carcinoembryonic antigen (CEA). There was no significant difference in serum HA, Col IV and lymph node metastasis preoperatively and postoperatively. No lymph node metastasis showed a decrease in HA and Col IV after operation, but there was no statistical difference (P > 0.05). The ColIV distribution in colorectal cancer tissues has a different degree of reduction and is inversely related to the Dukes stage of colorectal cancer.