血清Hcy，叶酸和维生素B12在胃癌及其癌前疾病中的作用

目的:探讨血清同型半胱氨酸(Hcy)、叶酸以及维生素B12在胃癌及癌前疾病中的水平及临床意义。方法:收集2014年1月至2016年8月我院收治的100例胃癌患者(胃癌组),及100例胃良性病变患者包括41例胃炎、34例胃溃疡、25例胃息肉(癌前病变组),并于同期随机选择200例健康体检者为对照组,采用循环酶法测定三组的血清Hcy,电化学发光免疫分析法测定叶酸及维生素B12水平,并分析各指标与胃癌临床病理特征的关系。结果:胃癌组、癌前病变组血清Hcy水平均高于对照组,叶酸及维生素B12水平均低于对照组,并且胃癌组血清Hcy水平高于癌前病变组,叶酸及维生素B12水平低于癌前病变组,差异有统计学意义(P0.05)。Ⅲ+Ⅳ期胃癌患者Hcy水平高于Ⅰ+Ⅱ期,进展期患者Hcy水平高于早期,有淋巴结转移患者Hcy水平高于无转移者,差异有统计学意义(P0.05);Hcy表达与性别、年龄、病变位置以及分化程度无关,差异无统计学意义(P0.05)。叶酸、维生素B12的表达在胃癌患者中与各临床病理特征(性别、年龄、TNM分期、肿瘤浸润深度、病变位置、有无淋巴结转移、分化程度)无明显关系,差异无统计学意义(P0.05)。结论:血清Hcy在胃癌患者中呈高水平表达,而叶酸及维生素B12呈低水平表达,联合检测三种指标有助于早期区分胃癌及癌前病变,同时血清Hcy还可能参与了胃癌的发生发展过程。Hcy、叶酸及维生素B12可作为早期鉴别诊断胃癌及其癌前病变的重要指标。

Role of Serum Hcy, Folic Acid and Vitamin B12 in Gastric Cancer and Precancerous Diseases

ABSTRACT Objective: To explore the expression and clinical significance of serum homocysteine (Hcy), folic acid and vitamin B12 in gastric cancer and precancerous diseases. Methods: 100 patients with gastric cancer (gastric cancer group) and 100 patients with benign gastric lesions including 41cases of gastritis, 34 cases of gastric ulcer, 25 cases of gastric polyps,(precancerous lesions group)who were treated in our hospital were collected from January 2014 to August 2016. At the same time, 200 healthy volunteers as control group were randomly selected. The serum Hcy level of three groups were detected by the cyclic enzymatic, and folic acid and vitamin B12 level were detected by the electrochemiluminescence immunoassay. And the associate between Hcy, folic acid, vitamin B12 and clinic patho- logical features in patients with gastric cancer were analyzed. Results: The serum Hcy of gastric cancer and precancerous lesions group was higher than that of control group, and folic acid, vitamin B12 were lower than those of precancerous lesions group,the difference was statistically significant(P<0.05). Moreover, the serum Hcy of gastric group was higher than that of control group,and folic acid, vitamin B12 were lower than those of precancerous lesions group, the difference was statistically significant(P<0.05). The serum Hcy in patients with III+IV gastric caner was higher than that in I+II gastric cancer, and the serum Hcy in patients with advanced gastric cancer was higher than that in earlier gastric cancer, and the serum Hcy in patients with lymph node metastasis was higher than that in patients with without metastasis, the difference was statistically significant(P<0.05). No association between Hcy expression and gender, age, location of le- sion, degree of differentiation was found(P<0.05). The expression of folic acid, vitamin B12 in clinic pathological features in patients with gastric cancer was no statistical significance(P>0.05). Conclusion: Serum Hcy is expressed at high levels in patients with gastric can- cer, and folic acid, vitamin B12 is expressed at low levels. Combing detection of three metrics can help to distinguish early gastric cancer and precancerous lesions. Serum Hcy may also be involved in the development of gastric cancer. Therefore, Hcy, folic acid and vitamin B12 can be used as an important indicator for early diagnosis of gastric cancer and precancerous lesions.