目的 探讨骨肉瘤患者治疗前血清肿瘤坏死因子-α(TNF-α)的水平及其与预后的关系.方法 采用酶联免疫吸附法(ELISA)分别测定56例骨肉瘤患者治疗前和50例健康对照者血清中TNF-α水平,分析骨肉瘤患者血清中TNF-α水平与临床病理特征及预后的关系.结果 56例骨肉瘤患者治疗前血清TNF-α为(32.08±19.68) pg/ml,显著高于健康对照者的(18.00±19.88) pg/ml,差异有统计学意义(P=0.04).骨肉瘤患者治疗前血清TNF-α水平与碱性磷酸酶水平(P=0.002)及肿瘤分期(P =0.026)有关.治疗前血清TNF-α升高患者(n=44)的中位生存时间为22.2个月,TNF-α水平正常者(n=12)为32.1个月,差异有统计学意义(P =0.037).结论 骨肉瘤患者治疗前血清TNF-α水平明显升高,且与预后相关,该指标对判断预后及指导治疗具有一定的参考价值.%Objective To investigate the serum level of tumor necrosis factor-a (TNF-a) in patients with osteosarcoma pre-treatment and its correlation with prognosis. Methods The serum levels of TNF-a in 56 patients with osteosarcoma before chemotherapy and 50 healthy people were detected by ELISA method. The factors affecting the serum TNF-a level of osteosarcoma patients and the correlation of TNF-a with prognosis were also studied. Results The expression of serum TNF-a pretreatment of 56 osteosarcoma patients was (32. 08 ± 19. 68) pg/ml, higher than (18. 00 ± 19. 88) pg/ml of the healthy people. There were statistical significances (P = 0.04). The level of TNF-a in osteosarcoma patients was correlated to alkaline phosphatase(P = 0. 002) and stage(P =0.026) . In osteosarcoma patients, the median overall survival ( OS) in elevated TNF-a group ( n = 44 ) was 22. 2 months, lower than 32. 1 months in normal TNF-a group. There were statistical significances (P =0. 037). Conclusion The level of serum TNF-a in patients with osteosarcoma is significantly increased, and is correlated to prognosis. The detection of serum TNF-a has certain value for prognosis and treatment of osteosarcoma.
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