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目的 :探讨血清新蝶呤与鼻咽癌的关系及临床意义。方法 :采用 EL ISA竞争法检测 5 4例初治鼻咽低分化鳞癌 (鼻咽癌组 )治疗前、后及 32例健康成人 (对照组 )的血清新蝶呤水平。结果 :鼻咽癌组新蝶呤浓度明显高于对照组 (P <0 .0 1)。各 TNM分期之间新蝶呤水平无差异 (P >0 .0 5 )。无淋巴结转移者血清新蝶呤浓度低于有淋巴结转移者 (P <0 .0 5 )。治疗后新蝶呤水平比治疗前明显降低 (P <0 .0 1) ,但仍比对照组高 (P <0 .0 1) ;治疗后 6个月病灶全消者新蝶呤水平仍维持较低水平而病灶部分残留者复又上升 (P <0 .0 1)。结论 :鼻咽癌病理发生过程中可能存在着巨噬细胞介导的细胞免疫过激或免疫应答异常 ;血清新蝶呤水平动态观察可作为鼻咽癌病情评估和疗效监测的一项客观指标。
Objective: To investigate the relationship between serum neopterin and nasopharyngeal carcinoma and its clinical significance. Methods: ELSA competitive assay was used to detect the levels of serum neopterin in 54 patients with nasopharyngeal poorly differentiated squamous cell carcinoma (NPC) before and after treatment and 32 healthy adults (control group). Results: The neopterin concentration in nasopharyngeal carcinoma group was significantly higher than that in control group (P <0.01). There was no difference in neopterin levels between TNM stages (P> 0.05). The serum neopterin concentration in patients without lymph node metastasis was lower than those with lymph node metastasis (P <0.05). Neopterin levels were significantly lower after treatment than before treatment (P <0.01), but still higher than the control group (P <0.01); 6 months after treatment, the levels of total neopterin in patients with lesions still maintained Lower levels of lesions and some residual persons increased again (P <0. 01). CONCLUSIONS: Macrophage-mediated over-stimulation of cellular immunity or abnormal immune response may exist during the pathogenesis of NPC. The dynamic observation of serum neopterin level may be used as an objective indicator of disease assessment and curative effect monitoring of NPC.