标题：食管癌患者术前术后血清Hcy、TSGF、IGF-Ⅱ的改变及临床意义

      作者：周敏杰 1，李少民 2，夏焘 1，刘瑛 3    (1.渭南市澄城县医院胸外科，陕西 渭南 715200；2.西安交通大学附属二院胸外科，陕西 西安 710006；3.渭南市澄城县医院检验科，陕西 渭南 715200)

      卷次： 2017年28卷8期

      【摘要】 目的 观察食管癌患者手术前后血清同型半胱氨酸(Hcy)、肿瘤特异性生长因子(TSGF)、胰岛素样生长因子-Ⅱ (IGF-Ⅱ)变化，探讨其对治疗的临床指导意义。方法 检测2015年1~8月渭南市澄城县医院胸外科37例食管癌患者手术前、术后1个月、术后6个月血清Hcy、TSGF、IGF-Ⅱ水平，比较患者手术前后血清Hcy、TSGF、IGF-Ⅱ水平的变化。同时选择同期30例健康体检者作为对照。结果 食管癌组患者手术前的Hcy、TSGF、IGF-Ⅱ水平分别为(17.91±3.82) μmol/L、(98.57±16.48) U/L、(2.26±0.51) U/L，均明显高于正常对照组，差异均有统计学意义(P<0.05)；食管癌组患者术后1个月的Hcy、TSGF、IGF-Ⅱ水平分别为(11.26±1.8) μmol/L、(41.62±9.3) U/L、(0.63±0.24) U/L，较术前均明显降低，差异均有统计学意义(P<0.05)；随访6个月，8例患者出现复发转移，8例复发患者的Hcy、TSGF、IGF-Ⅱ水平明显高于未复发患者，差异均有统计学意义(P<0.05)。结论 食管癌患者手术后Hcy、TSGF、IGF-Ⅱ显著下降，复发转移时显著升高，检测患者Hcy、TSGF、IGF-Ⅱ水平对手术疗效、预后的判断具有重要的指导意义。
      【关键词】 食管癌；手术；同型半胱氨酸；肿瘤特异性生长因子；胰岛素样生长因子-Ⅱ；临床意义
      【中图分类号】 R735.1 【文献标识码】 A 【文章编号】 1003—6350（2017）08—1278—03

Changes of serum Hcy, TSGF, IGF-Ⅱ in patients with esophageal carcinoma before and after operation and itsclinical significance.
ZHOU Min-jie 1, LI Shao-min 2, XIA Tao 1, LIU Ying 3. 1. Department of Thoracic Surgery,Chengcheng County Hospital, Weinan 715200, Shaanxi, CHINA; 2. Department of Thoracic Surgery, the Second AffiliatedHospital of Xi'an Jiaotong University, Xi'an 710006, Shaanxi, CHINA; 3. Department of Clinical Laboratory, ChengchengCounty Hospital, Weinan 715200, Shaanxi, CHINA
【Abstract】 Objective To observe the level changes of serum homocysteine (Hcy) and tumor specific growthfactor (TSGF) and insulin-like growth factor Ⅱ (IGF-Ⅱ) in the patients with esophageal cancer before and after opera-tion, so as to explore its clinical significance. Methods The levels of serum Hcy, TSGF, IGF-Ⅱ before operation, onemonth after operation and six months after operation in 37 patients with esophageal cancer in Thoracic Surgery Depart-ment of Chengcheng County Hospital from January 2015 to August 2015 were detected, and the level changes of serumHcy, TSGF and IGF-Ⅱ before and after operation were compared. Meanwhile, 30 healthy persons were selected as con-trol. Results Before operation, the levels of Hcy, TSGF, IGF-Ⅱ in the patients with esophageal cancer were (17.91±3.82) μmol/L, (98.57±16.48) U/L and (2.26±0.51) U/L, respectively, which were significantly higher than those in thenormal control group (P<0.05). One month after operation, the levels of Hcy, TSGF, IGF-Ⅱ in the patients with esopha-geal cancer were (11.26±1.8) μmol/L, (41.62±9.3) U/L and (0.63±0.24) U/L, respectively, which were significantly low-er than those before operation (P<0.05). Six months after follow-up, tumor recurrence and metastasis were found in 8patients, whose levels of Hcy, TSGF, IGF-Ⅱ were significantly higher than those in non-recurrent patients (P<0.05).Conclusion After operation, the levels of Hcy, TSGF, IGF-Ⅱ in patients with esophageal cancer significantly de-creased, but the levels in the patients with the recurrence and metastasis significantly increased. The level detection ofHcy, TSGF, IGF-Ⅱ in patients with esophageal cancer has important guiding significance for the evaluation of the cura-tive effect and prognosis.
      【Key words】 Esophageal cancer; Operation; Homocysteine; Tumor specific growth factor; Insulin-like growthfactor-Ⅱ; Clinical significance·论 著·doi:10.3969/j.issn.1003-6350.2017.08.025