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目的:探讨胃癌病人手术前后血清人附睾蛋白4(human epididymis protein 4,HE4)的变化及其在术后评估中的价值。方法:接受胃癌根治手术43例,非胃癌病人胃大部切除手术28例,分别收集术前和术后的静脉血。健康体检者35例采静脉血。化学发光法测定血清HE4水平。分析其手术前后的变化及其与病理分期、淋巴结转移的关系。结果:胃癌病人术前、术后HE4水平分别为(53.4±23.5)、(74.9±41.4)pmol/L,术后较术前有明显升高,差异有统计学意义(t=4.475,P<0.001)。胃癌病人术前HE4与非胃癌病人和健康体检者无统计学差异。T_1~T_4期病人的术后与术前HE4差值分别为(33.6±30.8)、(26.8±34.7)、(23.8±12.1)、(23.2±18.6)pmol/L,T1~T4组间差异无统计学意义(P>0.05)。淋巴结转移组升高幅度[(26.5±23.4)pmol/L]较无淋巴结转移组[(17.5±15.6)pmol/L]显著升高(F=5.663,P=0.022)。结论:胃癌病人术后HE4水平较术前显著升高,且淋巴结转移病人升高明显,对胃癌病人的术后恢复评估可能有重要价值。
Objective: To investigate the change of serum human epididymis protein 4 (HE4) in patients with gastric cancer before and after operation and its value in postoperative evaluation. Methods: Forty-three patients underwent radical operation of gastric cancer and 28 patients underwent subtotal gastrectomy for non-gastric cancer. Venous blood was collected before and after operation. 35 healthy subjects were collected venous blood. Chemiluminescence method for determination of serum HE4 level. To analyze the changes before and after surgery and its relationship with pathological stage and lymph node metastasis. Results: The preoperative and postoperative HE4 levels in gastric cancer patients were 53.4 ± 23.5 and 74.9 ± 41.4 pmol / L, respectively. The postoperative levels of HE4 were significantly higher than those before operation (t = 4.475, P < 0.001). Gastric cancer patients preoperative HE4 and non-gastric cancer patients and healthy subjects no significant difference. The differences of postoperative and preoperative HE4 in T_1 ~ T_4 patients were (33.6 ± 30.8), (26.8 ± 34.7), (23.8 ± 12.1) and (23.2 ± 18.6) pmol / L, respectively Statistical significance (P> 0.05). The increase of lymph node metastasis was significantly higher in group with lymph node metastasis ([(26.5 ± 23.4) pmol / L vs [17.5 ± 15.6] pmol / L in group without lymph node metastasis (F = 5.663, P = 0.022. CONCLUSIONS: The postoperative HE4 level in patients with gastric cancer is significantly higher than that before operation, and the patients with lymph node metastasis are elevated significantly. It may be of great value for the postoperative recovery assessment of patients with gastric cancer.