• 1.中國醫(yī)科大學(xué)附屬盛京醫(yī)院結(jié)直腸腫瘤肛門病外科（沈陽110004）;;
  • 2.中國醫(yī)科大學(xué)附屬第四醫(yī)院胃腸外科（沈陽 110032）;;
  • 3.遼寧中醫(yī)藥大學(xué)附屬醫(yī)院肛腸科（沈陽 110032）;

目的  探討血清瘦素水平與結(jié)直腸癌各種臨床病理改變的關(guān)系。方法  用雙抗體夾心ABC-ELISA法檢測30例無營養(yǎng)不良的結(jié)直腸癌患者（腫瘤組）和24例健康成年人（對照組）血清瘦素水平，分析結(jié)直腸癌不同臨床病理特征下血清瘦素水平的差異； 檢測腫瘤組患者的血清CEA及CA19-9水平，用RT-PCR方法測定腫瘤組腫瘤標(biāo)本中K-ras、p53、腺瘤性結(jié)腸息肉?。ˋPC）基因及結(jié)直腸癌缺失基因（DCC)mRNA的表達(dá)水平。結(jié)果  腫瘤組血清瘦素水平〔（3.53±1.72） μg/L〕明顯高于對照組〔（2.27±1.01） μg/L〕，P＜0.05，且這種差異與性別無關(guān)。腫瘤組中不同腫瘤部位、不同TNM分期間的血清瘦素水平差異無統(tǒng)計學(xué)意義（P gt;0.05）； 但隨著腫瘤分化程度的降低，血清瘦素水平呈現(xiàn)下降趨勢，其中低分化者的血清瘦素水平明顯低于高分化者和中分化者（P＜0.05）。腫瘤學(xué)的相關(guān)性分析結(jié)果顯示，血清瘦素水平與結(jié)直腸癌患者的血清CEA和CA19-9水平，腫瘤組織的癌基因K-ras以及抑癌基因p53、APC和DCC的表達(dá)均無相關(guān)性（P gt;0.05）。結(jié)論  結(jié)直腸癌患者血清中的瘦素水平高于正常人； 腫瘤的分化程度影響了血清瘦素的表達(dá)，但結(jié)直腸癌的TNM分期、部位和血清腫瘤標(biāo)志物的水平與血清瘦素水平無關(guān)，與結(jié)直腸癌發(fā)生、發(fā)展密切相關(guān)的各種基因的表達(dá)與血清瘦素水平也無關(guān)。

引用本文： 陳春生,叢進(jìn)春,沈名揚(yáng),王俊江,張宏,喬雷. 結(jié)直腸癌患者血清中瘦素表達(dá)的研究. 中國普外基礎(chǔ)與臨床雜志, 2009, 16(5): 379-383. doi: 復(fù)制

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4. Garofalo C, Surmacz E. Leptin and cancer [Ｊ]. J Cell Physiol, 2006; 207(1): 12-22.
5. Hardwick JC, Van Den Brink GR, Offerhaus GJ, et al. Leptin is a growth factor for colonic epithelial cells [Ｊ]. Gastroenterology, 2001; 121(1): 79-90.
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12. Stattin P, Lukanova A, Biessy C, et al. Obesity and colon cancer: does leptin provide a link? [Ｊ]. Int J Cancer, 2004; 109(1): 149-152.
13. Tamakoshi K, Toyoshima H, Wakai K, et al. Leptin is associated with an increased female colorectal cancer risk: a nested case-control study in Japan [Ｊ]. Oncology, 2005; 68(4-6): 454-461.
14. Stattin P, Palmqvist R, Sderberg S, et al. Plasma leptin and colorectal cancer risk: a prospective study in Northern Sweden [Ｊ]. Oncol Rep, 2003; 10(6): 2015-2021.
15. Bolukbas FF, Kilic H, Bolukbas C, et al. Serum leptin concentration and advanced gastrointestinal cancers: a case controlled study [Ｊ]. BMC Cancer, 2004; 4: 29.
16. Tessitore L, Vizio B, Jenkins O, et al. Leptin expression in colorectal and breast cancer patients [Ｊ]. Int J Mol Med, 2000; 5(4): 421-426.
17. Hong SJ, Kwon KW, Kim SG, et al. Variation in expression of gastric leptin according to differentiation and growth pattern in gastric adenocarcinoma [Ｊ]. Cytokine, 2006; 33(2): 66-71.
18. Grosfeld A, Andre J, Hauguel-De Mouzon S, et al. Hypoxia-inducible factor 1 transactivates the human leptin gene promoter [Ｊ]. J Biol Chem, 2002; 277(45): 42953-42957.
19. Koda M, Sulkowska M, Wincewicz A, et al. Expression of leptin, leptin receptor, and hypoxia-inducible factor 1 alpha in human endometrial cancer [Ｊ]. Ann N Y Acad Sci, 2007; 1095: 90-98.
20. Chaudhary M, Mandir N, FitzGerald AJ, et al. Starvation, leptin and epithelial cell proliferation in the gastrointestinal tract of the mouse [Ｊ]. Digestion, 2000; 61(4): 223-229.
21. Hirose Y, Hata K, Kuno T, et al. Enhancement of development of azoxymethane-induced colonic premalignant lesions in C57BL/KsJ-db/db mice [Ｊ]. Carcinogenesis, 2004; 25(5): 821-825.
22. Aparicio T, Guilmeau S, Goiot H, et al. Leptin reduces the development of the initial precancerous lesions induced by azoxymethane in the rat colonic mucosa [Ｊ]. Gastroenterology, 2004; 126(2): 499-510.
23. Ealey KN, Lu S, Archer MC. Development of aberrant crypt foci in the colons of ob/ob and db/db mice: evidence that leptin is not a promoter [Ｊ]. Mol Carcinog, 2008; 47(9): 667-677.
24. 張珊， 陳國慶， 唐鴻波, 等. 血清胰島素樣生長因子-1 對癌性惡病質(zhì)小鼠營養(yǎng)狀況的影響 [Ｊ]. 中國普外基礎(chǔ)與臨床雜志， 2008; 15（2）： 112-115.
25. 王治國, 楊喆, 秦環(huán)龍. 術(shù)前口服碳水化合物改善術(shù)后胰島素抵抗的作用及其機(jī)理研究 [Ｊ]. 中國普外基礎(chǔ)與臨床雜志， 2008; 15（11）： 799-804.
  1. 1. Frezza EE, Wachtel MS, Chiriva-Internati M. Influence of obesity on the risk of developing colon cancer [Ｊ]. Gut, 2006; 55(2): 285-291.
  2. 2. Zhang Y, Proenca R, Maffei M, et al. Positional cloning of the mouse obese gene and its human homologue [Ｊ]. Nature, 1994; 372(6505): 425-432.
  3. 3. Sauter ER, Garofalo C, Hewett J, et al. Leptin expression in breast nipple aspirate fluid (NAF) and serum is influenced by body mass index (BMI) but not by the presence of breast cancer [Ｊ]. Horm Metab Res, 2004; 36(5): 336-340.
  4. 4. Garofalo C, Surmacz E. Leptin and cancer [Ｊ]. J Cell Physiol, 2006; 207(1): 12-22.
  5. 5. Hardwick JC, Van Den Brink GR, Offerhaus GJ, et al. Leptin is a growth factor for colonic epithelial cells [Ｊ]. Gastroenterology, 2001; 121(1): 79-90.
  6. 6. Aparicio T, Kotelevets L, Tsocas A, et al. Leptin stimulates the proliferation of human colon cancer cells in vitro but does not promote the growth of colon cancer xenografts in nude mice or intestinal tumorigenesis in Apc(Min/+) mice [Ｊ]. Gut, 2005; 54(8): 1136-1145.
  7. 7. Falk RT, Brinton LA, Madigan MP, et al. Interrelationships between serum leptin, IGF-1, IGFBP3, C-peptide and prolactin and breast cancer risk in young women [Ｊ]. Breast Cancer Res Treat, 2006; 98(2): 157-165.
  8. 8. Stattin P, Sderberg S, Hallmans G, et al. Leptin is associated with increased prostate cancer risk: a nested case-referent study [Ｊ]. J Clin Endocrinol Metab, 2001; 86(3): 1341-1345.
  9. 9. Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002 [Ｊ]. Clin Nutr, 2003; 22(4): 415-421.
  10. 10. Wallace AM, Sattar N, McMillan DC. Effect of weight loss and the inflammatory response on leptin concentrations in gastrointestinal cancer patients [Ｊ]. Clin Cancer Res, 1998; 4(12): 2977-2979.
  11. 11. Ma Z, Gingerich RL, Santiago JV, et al. Radioimmunoassay of leptin in human plasma [Ｊ]. Clin Chem, 1996; 42(6 Pt 1): 942-946.
  12. 12. Stattin P, Lukanova A, Biessy C, et al. Obesity and colon cancer: does leptin provide a link? [Ｊ]. Int J Cancer, 2004; 109(1): 149-152.
  13. 13. Tamakoshi K, Toyoshima H, Wakai K, et al. Leptin is associated with an increased female colorectal cancer risk: a nested case-control study in Japan [Ｊ]. Oncology, 2005; 68(4-6): 454-461.
  14. 14. Stattin P, Palmqvist R, Sderberg S, et al. Plasma leptin and colorectal cancer risk: a prospective study in Northern Sweden [Ｊ]. Oncol Rep, 2003; 10(6): 2015-2021.
  15. 15. Bolukbas FF, Kilic H, Bolukbas C, et al. Serum leptin concentration and advanced gastrointestinal cancers: a case controlled study [Ｊ]. BMC Cancer, 2004; 4: 29.
  16. 16. Tessitore L, Vizio B, Jenkins O, et al. Leptin expression in colorectal and breast cancer patients [Ｊ]. Int J Mol Med, 2000; 5(4): 421-426.
  17. 17. Hong SJ, Kwon KW, Kim SG, et al. Variation in expression of gastric leptin according to differentiation and growth pattern in gastric adenocarcinoma [Ｊ]. Cytokine, 2006; 33(2): 66-71.
  18. 18. Grosfeld A, Andre J, Hauguel-De Mouzon S, et al. Hypoxia-inducible factor 1 transactivates the human leptin gene promoter [Ｊ]. J Biol Chem, 2002; 277(45): 42953-42957.
  19. 19. Koda M, Sulkowska M, Wincewicz A, et al. Expression of leptin, leptin receptor, and hypoxia-inducible factor 1 alpha in human endometrial cancer [Ｊ]. Ann N Y Acad Sci, 2007; 1095: 90-98.
  20. 20. Chaudhary M, Mandir N, FitzGerald AJ, et al. Starvation, leptin and epithelial cell proliferation in the gastrointestinal tract of the mouse [Ｊ]. Digestion, 2000; 61(4): 223-229.
  21. 21. Hirose Y, Hata K, Kuno T, et al. Enhancement of development of azoxymethane-induced colonic premalignant lesions in C57BL/KsJ-db/db mice [Ｊ]. Carcinogenesis, 2004; 25(5): 821-825.
  22. 22. Aparicio T, Guilmeau S, Goiot H, et al. Leptin reduces the development of the initial precancerous lesions induced by azoxymethane in the rat colonic mucosa [Ｊ]. Gastroenterology, 2004; 126(2): 499-510.
  23. 23. Ealey KN, Lu S, Archer MC. Development of aberrant crypt foci in the colons of ob/ob and db/db mice: evidence that leptin is not a promoter [Ｊ]. Mol Carcinog, 2008; 47(9): 667-677.
  24. 24. 張珊， 陳國慶， 唐鴻波, 等. 血清胰島素樣生長因子-1 對癌性惡病質(zhì)小鼠營養(yǎng)狀況的影響 [Ｊ]. 中國普外基礎(chǔ)與臨床雜志， 2008; 15（2）： 112-115.
  25. 25. 王治國, 楊喆, 秦環(huán)龍. 術(shù)前口服碳水化合物改善術(shù)后胰島素抵抗的作用及其機(jī)理研究 [Ｊ]. 中國普外基礎(chǔ)與臨床雜志， 2008; 15（11）： 799-804.