目的 研究血清透明质酸(HA)与胃癌诊断以及侵袭生长的关系.方法 收集2007年至2010年间上海市交通大学医学院附属新华医院普外科收治的96例胃癌患者的外周血,采用ELISA检测HA,分析其与胃癌患者临床病理特征的关系.结果 胃癌患者术前血清HA水平显著高于慢性胃炎组和健康对照组,分别为(144.69±84.97)ng/ml,(80.56±42.45)ng/ml,(59.91±35.52)ng/ml(P=0.003);在所有胃癌患者中,发现HA和胃癌的大小,淋巴结转移以及TNM分期呈正相关;即肿瘤越大(＞5cm),淋巴结转移阳性,进展期(III+IV)的HA水平显著高于肿瘤小,无淋巴结转移,肿瘤分期早的胃癌;HA和胃癌的病理类型无关.高HA的胃癌患者的术后中位生存期显著低于低表达组,分别为12.3个月和31.2个月(P=0.040);因素生存分析发现仅血清HA和肿瘤TNM分期是胃癌患者总体生存率的独立影响因素,其RR分别为2.449(95% CI为1.256～6.718,P=0.012)和3.649(95% CI为1.445～7.718,P=0.005).结论 血清HA和胃癌的侵袭性呈正相关,即进展期胃癌的血清HA水平更高;且血清HA和胃癌TNM分期是胃癌患者总体生存的独立危险因素.%Objective To explore the correlation between the serum hyaluronic acid (HA) and clinicopathological characteristic of gastric cancer. Methods The detection of serum HA by ELSIA were conducted in 96 gastric cancer patients who received radical resection in general surgery department of Xin Hua hospital from 2007 to 2010, and the clinicopathological characteristic of gastric cancer were analyzed. Results The serum HA level was much higher in gastric cancer than chronic gastritis and healthy control group(144.69 ± 84. 97) ng/ml vs (80.56 ±42.45) ng/ml vs (59.91 ± 35.52) ng/ml, P = 0.003);furthermore, we found much higher serum level of HA in much larger tumor ( ＞ 5cm) and advance tumor stage (Ⅲ + Ⅳ); Higher serum HA group had lower median survival times ( 12. 3 months versus 31.2months, P = 0. 040) , and serum HA and AJCC/UICC tumor staging were two independent risk factors for overall - survival ( OR: 2. 449, 95％ CI :. 256 - 6. 718 ,P = 0. 012; OR: 3. 649,95％ CI: 1. 445 -7. 718,P = 0. 005). Conclusion Serum HA has positive correlation with aggressive behavior of gastric caner,and it is the independent risk factors for overall survival of gastric cancer.
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