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目的探讨胃癌患者血清中可溶性肿瘤坏死因子受体 Ⅱ（ｓＴＮＦＲⅡ）的水平及临床意义。方法应用Ｅｌｉｓａ方法检测 ３９例胃腺癌患者术前、术后 １４天外周血及术中胃左静脉血ｓＴＮＦＲⅡ水平，并以正常献血员作正常对照组。所有病例术后随访 １年以上。结果（１）胃癌外周血及胃左静脉血ｓＴＮＦＲⅡ均高于正常对照组；且胃左静脉血ｓＴＮＦＲⅡ明显高于外周静脉血；（２）术前外周静脉血ｓＴＮＦＲⅡ水平与肿瘤大小、肿瘤侵犯深度、有否淋巴结转移及远处转移、ＵＩＣＣ分期、肿瘤分化程度无关；胃左静脉血ｓＴＮＦＲ Ⅱ水平在肿瘤侵出或侵犯浆膜、有远处转移及肿瘤低～未分化组明显高于肿瘤局限于肌层或粘膜内、无远处转移及高～中分化腺癌者；（３）随访期间复发或死亡１８例，健在组 ２１例术中胃左静脉血及术后 ２周外周静脉血ｓＴＮＦＲⅡ明显低于复发或死亡组。结论胃癌患者存在高水平的 ｓＴＮＦＲⅡ．且肿瘤的引流静脉存在更高水平的 ｓＴＮＦＲⅡ，在肿瘤累及浆膜时其增高更加明显。显示肿瘤坏死因子可能在其生成的局部发挥短程作用；术后仍维持较高水平ｓＴＮＦＲⅡ者常提示预后不良。
Objective To investigate the level and clinical significance of soluble tumor necrosis factor receptor II (sTNFRII) in serum of gastric cancer patients. Methods Elisa was used to detect the blood sTNFRII levels in 39 cases of gastric adenocarcinoma before and 14 days after operation, and normal blood donors were used as normal control group. All patients were followed up for more than 1 year. Results (1) The sTNFRII levels in peripheral blood and left gastric vein of gastric cancer were significantly higher than those in the normal control group. The serum level of sTNFRII in left gastric vein was significantly higher than that in peripheral vein blood; (2) The level of sTNFRII in peripheral blood and the size and depth of tumor invasion before operation. There was no association between lymph node metastasis and distant metastasis, UICC stage, and tumor differentiation. The level of sTNFR II in left gastric vein blood was significantly higher than that of tumor in invasion or invasion of serosa, distant metastasis, and low or undifferentiated tumors. In muscle or mucosa, no distant metastasis, and high to moderately differentiated adenocarcinoma; (3) 18 cases of relapse or death during follow-up, 21 cases of intraoperative left gastric vein blood in healthy group and 2 weeks of peripheral venous blood sTNFRII Significantly lower than the relapse or death group. Conclusion There is a high level of sTNFRII in gastric cancer patients. In addition, there was a higher level of sTNFRII in the draining vein of the tumor, which was more pronounced when the tumor involving the serosa. It has been shown that tumor necrosis factor may exert a short-range effect in the areas where it is produced; patients who maintain a high level of sTNFRII after surgery often have a poor prognosis.