慢性胃炎和胃癌患者血清CRP、IL-32水平及其意义

发布时间：2018-03-09 01:26

本文选题：白介素-32　切入点：C反应蛋白　出处：《青海大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：通过测定慢性浅表性胃炎、慢性萎缩性胃炎、癌前病变、胃癌患者血清中CRP、IL-32浓度，探讨二者与上述疾病的关系，寻找有助于早期诊断胃癌的血清学依据。方法收集2013年2月－2013年12月因消化道症状前来青海大学附属医院消化科住院诊治患者131例，慢性浅表性胃炎（对照组）27例、慢性萎缩性胃炎38例、癌前病变31例以及胃癌35例，并行14C呼气试验判定Hp感染情况。采用散射比浊法测定CRP水平，，酶联免疫吸附法（ELISA）检测IL-32的水平，并进行比较分析。结果：1.胃癌组血清CRP和IL-32水平高于癌前病变组、萎缩性胃炎组和对照组，(P＜0.05)，癌前病变组血清CRP和IL-32水平高于萎缩性胃炎组和对照组(P＜0.05)，而萎缩性胃炎组血清CRP、IL-32与对照组相比无明显差异(P＞0.05)。2.在癌前病变组和胃癌组中，Hp（+）者血清CRP和IL-32水平高于Hp（-）者，差异有统计学意义(P＜0.05)；而在对照组和慢性萎缩性胃炎组中，Hp（+）者血清CRP、IL-32水平与HP（-）者比较差异无统计学意义(P＞0.05)。3.癌前病变组血清IL-32与CRP是正相关，r=0.615，P＜0.05；胃癌组血清IL-32、CRP是正相关，r=0.775，P＜0.05。结论：1.癌前病变组和胃癌组患者血清CRP和IL-32浓度明显高于萎缩性胃炎组和对照组，且胃癌组高于癌前病变组，提示胃粘膜病变较重时，炎症相关因子CRP和促炎因子IL-32表达活跃，有望作为胃癌的早期预警指标。2.在癌前病变组和胃癌组中，Hp（+）者血清CRP和IL-32水平均高于Hp（-）者，而在对照组和萎缩性胃炎组中，Hp（+）者与Hp（-）者无明显差异，可能提示Hp感染初期机体产生的抗炎因子可阻止炎症反应过度，若炎症持续存在，抗炎因子无法阻止炎症的侵袭，最终诱发并促进胃癌的发生和扩散。3. IL-32和CRP在癌前病变组和胃癌组中均具有明显的正相关， IL-32可促进细胞因子释放，从而刺激肝细胞分泌并释放CRP，推测IL-32与CRP是胃癌发生过程中的主要炎性介质。
[Abstract]:Objective: To explore the relationship between the two factors and the above diseases by determining serum CRP and IL-32 concentrations in patients with chronic superficial gastritis, chronic atrophic gastritis, precancerous lesions and gastric cancer, and to find serological evidence for early diagnosis of gastric cancer.
Methods from February 2013 to December 2013 due to gastrointestinal symptoms of digestive department of Affiliated Hospital of Qinghai University hospital diagnosis and treatment of 131 cases of patients with chronic superficial gastritis (control group) 27 cases, 38 cases of chronic atrophic gastritis, 31 cases of precancerous lesion and 35 cases of gastric cancer, parallel 14C breath test to determine Hp infection. The level of CRP was measured by nephelometry methods enzyme linked immunosorbent assay (ELISA) to detect the level of IL-32, and comparative analysis.
Results: 1. gastric cancer group serum CRP and IL-32 level is higher than that of precancerous lesions of chronic atrophic gastritis group and control group (P < 0.05), precancerous lesion group serum CRP and IL-32 levels were significantly higher in atrophic gastritis group and control group (P < 0.05), and atrophic gastritis group serum CRP, IL-32 and control group showed no significant difference (P > 0.05).2. in precancerous lesions and gastric cancer group, Hp (+) CRP and serum level of IL-32 was higher than that of Hp (-), the difference was statistically significant (P < 0.05); while in the control group and chronic atrophic gastritis group, Hp (+) serum CRP, IL-32 level and HP (-) there was no significant difference (P > 0.05).3. precancerous lesion group serum IL-32 and CRP is positively related to r=0.615, P < 0.05; gastric cancer group serum IL-32, CRP is positively related to r=0.775, P < 0.05.
Conclusion: 1. precancerous lesions and gastric cancer patients serum CRP and IL-32 concentrations were significantly higher than those in atrophic gastritis group and control group, and the gastric cancer group was higher than that of precancerous lesions of gastric mucosal lesions that are heavier, inflammation related factors CRP and proinflammatory cytokine expression of IL-32 active, is expected as early warning indicators of.2. in gastric cancer precancerous lesions and gastric cancer group, Hp (+) CRP and serum IL-32 levels were significantly higher than that of Hp (-), while in the control group and atrophic gastritis group, Hp (+) and Hp (-) have no obvious difference, may suggest anti-inflammatory factor Hp early infection of the body to produce can to prevent excessive inflammation, if inflammation persists, anti-inflammatory factor cannot prevent inflammation and promote gastric cancer invasion, induce the occurrence and spread of.3., IL-32 and CRP in precancerous lesions and gastric cancer patients have obvious positive correlation, IL-32 can promote the release of cytokines, which stimulate liver cells CRP is secreted and released, and it is presumed that IL-32 and CRP are the main inflammatory mediators in the process of gastric cancer.

【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R573.3;R735.2

【参考文献】