癌胚抗原-125和细胞间粘附分子-1共同作为肝硬化腹水的评价指标

发布时间：2018-10-12 18:57

【摘要】：背景：癌胚抗原125是一种高分子量的糖蛋白,主要用于诊断卵巢癌。但在许多良性疾病,特别是肝硬化中,可以观察到CA125升高,但其升高的原因尚不清楚。相似的,细胞间粘附分子(ICAM1)是一个90kD的跨膜糖蛋白,是白细胞功能相关抗原的配体,也有报道在肝硬化中同样升高,但在肝硬化和腹水中的作用还不清楚。已经证实,在慢性肝病患者中检测血清ICAM-1(sICAM-1)水平具有临床意义。方法：该研究共纳入76名被诊断为肝硬化,BuddChairi综合症和结核性腹膜炎的患者,所有病人均为山东大学齐鲁医院消化内科住院患。根据标准将腹水分为为轻度、中度和度三级。所有患者的癌胚抗原-125和sICAM-1与其他肝功指标一起被检测,然后评估CA-125与ICAM1与腹水的相关性。该研究分两阶段完成。第一阶段只包括肝硬化患者,在第二阶段同时纳入结核性腹膜炎、Budd Chairi综合症等良性疾病患者,然后将所有的患者根据有无腹水分为两个亚组。CA-125通过Elecsys CA125|CalSet(罗氏公司、瑞士)Elecsys2010(罗氏公司、瑞士)免疫分析系统使用单克隆抗体进行检测。ICAM1的通过测量可溶性的ICAM1(s ICAM-1)来完成。细胞间粘附分子1酶联免疫试剂盒(Chemicon)通过Elecsys2010(罗氏公司、瑞士)免疫系统用于测量s ICAM-1。结果：肝硬化病人CA-125水平与腹水的度呈强相关,同时与肝功指标无相关性。肝硬化患者是否合并有腹水,其CA-125水平有着显著差异,p0.05。所有出现腹水的患者ca125水平均升高(均值261.11±118.15),而大多数没有腹水的患者ca-125水平在正常范围。CA-125的水平和腹p0.05。水的量呈强相关,在肝硬化合并腹水患者以及其他合并腹水的良性疾病患者中,sICAM-1明显升高(sICAM平均值7.23±4.12和6.67±2.99)。肝硬化患者有无腹水其Sicam有显著差异,P0.05。结论：肝硬化患者癌胚抗原-125升高与腹水相关。腹膜因表面积巨大,其间皮细胞在癌胚抗原-125升高中起主要作用。因此ca-125可以作为早期诊断腹水的一个良好的标志物且ca-125和产生腹水的良性疾病的病因无关。ICAM-1通过影响内皮血管通透性,在腹水形成中起着关键作用,因此它和ca-125可以用作诊断腹水,监测疾病进展和严重程度的标志物或备选指标。
[Abstract]:Background: carcinoembryonic antigen 125 is a high molecular weight glycoprotein, mainly used in the diagnosis of ovarian cancer. However, elevated CA125 levels can be observed in many benign diseases, especially cirrhosis, but the reasons for this increase are unclear. Similarly, intercellular adhesion molecule (ICAM1) is a transmembrane glycoprotein of 90kD, a ligand of leukocyte function-related antigen, and is also reported to be elevated in cirrhosis, but its role in cirrhosis and ascites is unclear. Detection of serum ICAM-1 (sICAM-1) levels in patients with chronic liver disease has been confirmed to be of clinical significance. Methods: a total of 76 patients with cirrhosis, BuddChairi syndrome and tuberculous peritonitis were enrolled in the study, all of whom were hospitalized in the Department of Digestive Medicine, Qilu Hospital, Shandong University. Ascites are classified as mild, moderate, and grade according to the criteria. Carcinoembryonic antigen-125 and sICAM-1 were detected with other liver function markers in all patients, and the correlation between CA-125 and ICAM1 and ascites was evaluated. The study was completed in two stages. In the first stage, only patients with cirrhosis were included, and patients with benign diseases such as tuberculous peritonitis, Budd Chairi syndrome, were also included in the second stage. All patients were then divided into two subgroups according to whether they had ascites. CA-125 passed through Elecsys CA125 CalSet. Elecsys2010 (Roche, Switzerland) immunoassay system is tested using monoclonal antibodies. ICAM1 is performed by measuring soluble ICAM1 (s ICAM-1). Intercellular adhesion molecule-1 enzyme linked immunosorbent kit (Chemicon) is used to measure s ICAM-1. through the Elecsys2010 (Roche, Switzerland) immune system Results: the level of CA-125 was strongly correlated with the degree of ascites, but not correlated with liver function. There was a significant difference in CA-125 levels between patients with cirrhosis and ascites (p 0.05). Ca125 levels in all patients with ascites increased (mean 261.11 卤118.15), while ca-125 levels in most patients without ascites were in the normal range. There was a strong correlation between the quantity of water and sICAM-1 in patients with cirrhosis and ascites and other benign diseases with ascites (sICAM mean 7.23 卤4.12 and 6.67 卤2.99). There was significant difference in Sicam in patients with cirrhosis with or without ascites (P 0.05). Conclusion: the increase of carcinoembryonic antigen-125 is associated with ascites in cirrhotic patients. Because of the large surface area of peritoneum, mesothelial cells play a major role in carcinoembryonic antigen 125 liters. Therefore, ca-125 can be used as a good marker for early diagnosis of ascites and ca-125 is not related to the etiology of benign ascites. ICAM-1 plays a key role in the formation of ascites by affecting endothelial vascular permeability. Therefore, it and ca-125 can be used as markers or alternative indicators for the diagnosis of ascites and for monitoring the progression and severity of the disease.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.2

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