薛鸣 耿超

【摘 要】目的：探讨胸苷激酶1在结肠癌患者血清中的表达，为患者诊断、治疗提供参考。方法：2016年5月-2017年4月北大医疗鲁中医院初诊结肠癌病人94例，设为观察组。取相同时期入院的健康体检者70例，设为对照组。采用化学发光联合斑点杂交的技术检测两组TK1水平;对于观察组患者中的远处转移患者给予化学治疗，治疗后再次完成TK1水平测定;对观察组中的手术治疗患者分析血清TK1与其病理的相关性。结果：观察组TK1、CEA、CA199水平，均高于对照组（P<0.05）;远处转移患者血清TK1高于局部可手术患者（P<0.05）。不同肿瘤标志物联合诊断优于单一肿瘤标志物诊断。PR患者治疗后TK1水平，均低于SD及PD患者，PR患者治疗后TK1较化疗前显著降低（P<0.05）。提示TK1早于CEA、CA199提前预测肿瘤复发转移。结论：TK1评估结肠癌患者化疗疗效显著，建议联合影像学检查综合判定;TK1可作为结肠癌患者手术效果的判定及复发转移的预测指标之一。

【关键词】胸苷激酶1;结肠癌;癌胚抗原

Abstract：Objective To investigate the expression of thymidine kinase 1 in serum of patients with colon cancer， and to provide a reference method for diagnosis and treatment of patients.Methods： 94 patients with colon cancer newly diagnosed in PKUCare Luzhong Hospital from May 2016 to April 2017 were set as observation group. 70 healthy patients admitted to the hospital in the same period were selected as the control group. The TK1 levels of the two groups were detected by chemiluminescence combined spot hybridization. Chemotherapy was given to patients with distant metastasis in the observation group， and TR1 level was measured again after treatment. The correlation between serum TK1 and pathology was analyzed in the observation group. Results： the levels of TK1， CEA and CA199 in the observation group were higher than those in the control group （P<0.05）. The serum TK1 of patients with distant metastasis was higher than that of patients with local surgery （P<0.05）， and the combined diagnosis of different tumor markers was better than that of single tumor marker. The TK1 level of PR patients after treatment was lower than that of SD patients and PD patients， and the TK1 level of PR patients after treatment was significantly lower than that before chemotherapy （P<0.05）， suggesting that TK1 was earlier than CEA and CA199 in predicting tumor recurrence and metastasis.Conclusion： TKL evaluation of colon cancer patients with significant curative effect of chemotherapy， it is recommended to combine imaging examination comprehensive judgment; TK1 can be used as a predictor of recurrence and metastasis in patients with colon cancer

Key words： thymidine kinase 1;colon cancer;cancer embryo antigen

隨着基因检测及病理技术的进展，靶向药物在结肠癌患者中得到应用，提高了治疗的有效率。而肿瘤标志物在诊断和判断预后，肿瘤分类以及制定最佳治疗方案方面发挥重要作用[1]。胸苷激酶1（Thymidine Kinase，TK1）是人体内重要的生物酶，能促进胸苷嘧啶磷酸化，参与DNA复制和细胞增殖。正常细胞分裂后体液中不存在TK1。多项大样本临床调查结果均显示，癌症患者血清TK1活性是明显升高的[2]。通过观察TK1水平变化，以早期筛查肿瘤，评价患者预后及监控患者治疗效果。

1 材料和方法

1.1 资料

2016年5月-2017年4月在北大医疗鲁中医院初诊的结肠癌患者94例，年龄（60.74±10.91）岁，设为观察组，其中21例因出现远处转移，未行手术治疗。余73例患者均行结肠癌根治术。术后肿瘤TNM分期：I期5例，II期27例，III期41例。术后行规范辅助治疗及定期复查，中位随诊时间1.5年，共随访70例患者。取同期入院健康体检者70例，设为对照组，男42例，女28例，年龄（35-86）岁，平均（61.91±7.54）岁。

1.2 方法

对照组……