肺癌患者血清性激素水平的变化及意义(1)
【摘要】 目的 检测男性及绝经期女性肺癌患者外周血性激素水平并探讨其对肺癌诊断、治疗的价值。方法 采用化学发光免疫分析技术测定98例肺腺癌患者(27例术前患者、42例术后患者、29例术后化疗后患者)、30例肺良性病患者和30例健康人血清中雌二醇及睾酮水平,并探讨治疗手段对血清性激素的影响。结果 与对照组相比,各组肺癌患者T水平降低,E2水平和E2/T明显升高;与术后患者相比,肺癌术前组T水平降低(P<0.05),E2水平和E2/T统计学升高(P<0.01);而术后化疗前后肺癌组患者E2水平、E2/T、T水平无统计学差异(P>0.05)。男性及绝经期女性患者E2水平、E2/T比值无明显差异(P>0.05)。结论 男性及绝经后女性肺癌患者血清中存在性激素代谢的失衡与紊乱,检测肺腺癌患者血清E2、T水平和E2/T对肺癌的诊断具有一定的辅助价值;化疗不能改变肺癌患者的内分泌紊乱,可能需要相应的内分泌治疗。
【关键词】 肺肿瘤;雌二醇;睾酮
Levels of sexual hormones in plasma of male patients with lung cancer and their clinical significance
GU Yulan,ZHANG Ziwen,LI Lu,et al.
Department of oncology,ChangShu No.2 People’s Hospital, Chang shu 215500, China
【Abstract】 Objective To determine the levels of several sexual hormones in plasma of patientswith lung cancer and to evaluate their clinical significance.Methods The levels of estradiol (E2) and testosterone (T)) in plasma of 98 patients with lung cancer, 30 patients with several pulmonary disease, and 30 healthy men were measured by enzyme immunoassay magnetic solidphase. The difference of sexual hormone levels was compared amonglung cancer patients by different therapy stage.Results Compared with control group,the E2 level and the ratio of E2/Twere significantly increased inpatients with lung cancer. Compared with preoperative group, the level of plasma E2 in postoperative group (56±12.8) was significantly decreased (P<0.05), but there was no difference after chemotherapy (P>0.05).There was no difference between male patients and and postmenopausal female patients (P>0.05).Conclusion There are disorders and imbalances of sexual hormone metabolism in male and postmenopausal female patients with lung cancer. The determination of the levels of T, E2and the ratio of E2/T might be helpful for the diagnosis of male lung cancer.Chemotherapy can not modify the patients endocrine imbalance,which needs corroding endocrinetherapy.
【Key words】 Pulmonary neoplasms;Estradiol;Testosterone
肺癌是目前发病率和死亡率增长最快、对人类生命健康威胁最大的恶性肿瘤。临床上发现的肺癌患者就诊时已有2/3处于肿瘤晚期,失去了有效治疗的最佳时机[1]。为了做到肿瘤患者的早期发现、早期诊断、早期治疗,临床上应用各种各样的方法和手段,但仍不能令人满意。国内外研究表明,男性肺癌患者体内存在性激素分泌的紊乱[2,3]。笔者应用化学发光免疫分析技术(Chemiluminescenc Immunoassay),检测98例肺腺癌患者及30例健康人群中血清中雌二醇(estradiol, E2)、睾酮(testosterone,T)水平,并探讨治疗手段对性激素的影响。
1 对象与方法
1.1 研究对象 标本取自2006年10月至2008年10月间本院治疗的肺腺癌患者98例,男73例,女(绝经后)25例;年龄38~76岁,平均56.3岁;术前未化疗患者27例(术前组),术后未化疗患者42例(术后组),术后化疗后随访患者29例(复查组),均经临床病理或细胞学证实。病理类型:高分化腺癌41例, 中分化腺癌25例, 低分化腺癌32例;按1998年国际WHO肺癌TNM分期标准,Ⅱ期3例,Ⅲ期53例,Ⅳ期42例。所有患者均无急慢性心肝肾及内分泌疾病,无近期应用激素类药物史。各组患者在性别、年龄、肿瘤类型及分期方面资料有可比性。正常人群对照组30例,男21例,女(绝经后)9例;年龄39~75岁,平均54.8岁,系单位职工健康查体人员,体格健康,无心肺肝肾及内分泌疾患,无近期应用激素类药物史。
1.2 检测指标及检测试剂 检测指标为血清中雌二醇、睾酮,所用试剂均为美国拜耳公司产品。
1.3 标本采集及检测方法 本研究对象均于清晨空腹采集静脉血4 ml,2000 r/min离心5 min,取上层血清20℃低温保存待检。应用美国拜耳公司生产的ACS180型全自动化学发光免疫分析仪测所有标本,按产品说明书程序进行严格操作。
1.4 统计学方法 采用t检验及方差分析方法。
2 结果
2.1 肺腺癌患者与正常人群血清中性激素水平的比较肺癌患者中术前组E2值为(107±52.8) nmol/L ,明显高于正常组的(36±11.5)nmol/L(P<0.05),T值为(10.3±5.8) nmol/L,明显低于正常组的(18.4±6.5)nmol/L(P<0.05);术后组E2值为(56±12.8) nmol/L ,高于正常组(P<0.05),T值为(13.6±4.5) nmol/L,明显低于正常组(P<0.05);复查组E2值为(33±6.4) nmol/L, T值为(16.3±7.1) nmol/L,与正常组相仿;E2/T比值,肺癌术前组和术后组明显高于正常组(P<0.01)。见表1。, http://www.100md.com(顾玉兰 张子文 李 璐 黄 挺)
【关键词】 肺肿瘤;雌二醇;睾酮
Levels of sexual hormones in plasma of male patients with lung cancer and their clinical significance
GU Yulan,ZHANG Ziwen,LI Lu,et al.
Department of oncology,ChangShu No.2 People’s Hospital, Chang shu 215500, China
【Abstract】 Objective To determine the levels of several sexual hormones in plasma of patientswith lung cancer and to evaluate their clinical significance.Methods The levels of estradiol (E2) and testosterone (T)) in plasma of 98 patients with lung cancer, 30 patients with several pulmonary disease, and 30 healthy men were measured by enzyme immunoassay magnetic solidphase. The difference of sexual hormone levels was compared amonglung cancer patients by different therapy stage.Results Compared with control group,the E2 level and the ratio of E2/Twere significantly increased inpatients with lung cancer. Compared with preoperative group, the level of plasma E2 in postoperative group (56±12.8) was significantly decreased (P<0.05), but there was no difference after chemotherapy (P>0.05).There was no difference between male patients and and postmenopausal female patients (P>0.05).Conclusion There are disorders and imbalances of sexual hormone metabolism in male and postmenopausal female patients with lung cancer. The determination of the levels of T, E2and the ratio of E2/T might be helpful for the diagnosis of male lung cancer.Chemotherapy can not modify the patients endocrine imbalance,which needs corroding endocrinetherapy.
【Key words】 Pulmonary neoplasms;Estradiol;Testosterone
肺癌是目前发病率和死亡率增长最快、对人类生命健康威胁最大的恶性肿瘤。临床上发现的肺癌患者就诊时已有2/3处于肿瘤晚期,失去了有效治疗的最佳时机[1]。为了做到肿瘤患者的早期发现、早期诊断、早期治疗,临床上应用各种各样的方法和手段,但仍不能令人满意。国内外研究表明,男性肺癌患者体内存在性激素分泌的紊乱[2,3]。笔者应用化学发光免疫分析技术(Chemiluminescenc Immunoassay),检测98例肺腺癌患者及30例健康人群中血清中雌二醇(estradiol, E2)、睾酮(testosterone,T)水平,并探讨治疗手段对性激素的影响。
1 对象与方法
1.1 研究对象 标本取自2006年10月至2008年10月间本院治疗的肺腺癌患者98例,男73例,女(绝经后)25例;年龄38~76岁,平均56.3岁;术前未化疗患者27例(术前组),术后未化疗患者42例(术后组),术后化疗后随访患者29例(复查组),均经临床病理或细胞学证实。病理类型:高分化腺癌41例, 中分化腺癌25例, 低分化腺癌32例;按1998年国际WHO肺癌TNM分期标准,Ⅱ期3例,Ⅲ期53例,Ⅳ期42例。所有患者均无急慢性心肝肾及内分泌疾病,无近期应用激素类药物史。各组患者在性别、年龄、肿瘤类型及分期方面资料有可比性。正常人群对照组30例,男21例,女(绝经后)9例;年龄39~75岁,平均54.8岁,系单位职工健康查体人员,体格健康,无心肺肝肾及内分泌疾患,无近期应用激素类药物史。
1.2 检测指标及检测试剂 检测指标为血清中雌二醇、睾酮,所用试剂均为美国拜耳公司产品。
1.3 标本采集及检测方法 本研究对象均于清晨空腹采集静脉血4 ml,2000 r/min离心5 min,取上层血清20℃低温保存待检。应用美国拜耳公司生产的ACS180型全自动化学发光免疫分析仪测所有标本,按产品说明书程序进行严格操作。
1.4 统计学方法 采用t检验及方差分析方法。
2 结果
2.1 肺腺癌患者与正常人群血清中性激素水平的比较肺癌患者中术前组E2值为(107±52.8) nmol/L ,明显高于正常组的(36±11.5)nmol/L(P<0.05),T值为(10.3±5.8) nmol/L,明显低于正常组的(18.4±6.5)nmol/L(P<0.05);术后组E2值为(56±12.8) nmol/L ,高于正常组(P<0.05),T值为(13.6±4.5) nmol/L,明显低于正常组(P<0.05);复查组E2值为(33±6.4) nmol/L, T值为(16.3±7.1) nmol/L,与正常组相仿;E2/T比值,肺癌术前组和术后组明显高于正常组(P<0.01)。见表1。, http://www.100md.com(顾玉兰 张子文 李 璐 黄 挺)