目的：探讨血清细胞因子在胃腺癌早期筛查及进展评估中的临床应用价值。方法：收集2017 年11 月至2018 年2 月在山西省肿瘤医院经病理确诊的81 例胃腺癌患者（胃癌组）和85 例健康体检者（对照组）的外周血标本，应用AimPlex 流式高通量多因子检测技术检测两组人群血清中17 种细胞因子（包括IL-1β、IL-2、IL-4、IL-6、IL-8、IL-10、IL-12p70、IL-15、IL-17A、TNF-α、TNF-β、GM-CSF、G-CSF、IFN-γ、IP-10、MCP-1 和VEGF-A）的水平。应用受试者工作特征曲线进行诊断价值分析。结果：胃癌组患者血清IL-10、IL-8、IL-6、IP-10、MCP-1、VEGF-A和IL-12p70 的水平显著高于对照组（均P<0.01）；晚期胃癌组（Ⅲ/Ⅳ期）的IL-8、IL-6 和VEGF-A 的水平显著高于早期胃癌组（Ⅰ/Ⅱ期）（均P<0.01）。在区分早期胃癌组与对照组中，IL-8、IL-6、IL-10、IP-10、MCP-1、IL-12p70 和VEGF-A 的曲线下面积（AUC）分别是0.98、0.92、0.89、0.84、0.76、0.74 和0.58；其中IL-8、IL-6 和IL-10 的敏感性分别是97.4%、89.5%和97.4%，特异性分别是87.1%、85.9%和77.6%。在区分晚期胃癌组与早期胃癌组中，IL-8、IL-6 和VEGF-A的AUC分别是0.82、0.72 和0.69，敏感性分别是83.7%、60.5%和41.9%，特异性分别是71.1%、76.3%和92.1%。结论：血清IL-8、IL-6 和IL-10 联合检测有望用于胃腺癌的早期筛查，IL-8、IL-6 和VEGF-A的联合检测可用来评估胃腺癌进展程度。

Objective: To explore the clinical significance of multiple serum cytokines in early diagnosis and progression assessment of gastric adenocarcinoma. Methods: Peripheral blood samples of 85 healthy subjects (healthy control group) and 81 patients with pathologically confirmed gastric adenocarcinoma (gastric cancer group) were collected from November 2017 to February 2018 at Shanxi Cancer Hospital.Serum levels of 17 cytokines (including IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-15, IL-17A, TNF-α, TNF-β, GM-CSF, G-CSF,IFN-γ, IP-10, MCP-1 and VEGF-A) were measured byAimPlex multiplex assay technology. Their diagnostic values were analyzed by receiver operating characteristic (ROC) curve. Results: Serum levels of IL-10, IL-8, IL-6, IP-10, MCP-1, VEGF-A and IL-12p70 were significantly higher in gastric cancer patients than those in healthy controls (all P<0.01). There were significantly increased levels of IL-8, IL-6 and VEGF-Ain advanced-stage gastric cancer (stage I/II) group over early-stage gastric cancer (stage III/IV) group (all P<0.01). AUC (areas under the curve) of IL-8, IL-6, IL-10, IP-10, MCP-1, IL-12p70 and VEGF-A for distinguishing early-stage gastric cancer patients from healthy controls was 0.98, 0.92, 0.89, 0.84, 0.76, 0.74 and 0.58, respectively. The diagnostic sensitivity of IL-8, IL-6 and IL-10 was 97.4%, 89.5% and 97.4%, respectively, and the specificity was 87.1%, 85.9%and 77.6%, respectively. TheAUC of IL-8, IL-6 and VEGF-Afor distinguishing advanced-stage gastric cancer patients from early-stage gastric cancer patients was 0.82, 0.72 and 0.69, respectively. Thediagnosticsensitivity of IL-8, IL-6 and VEGF-A was 83.7%, 60.5% and 41.9%, respectively, and the specificity was 71.1%, 76.3%and 92.1%, respectively.Conclusion: The combined detection of serumIL-8, IL-6 and IL-10 may be a potential approach for early screening of gastric adenocarcinoma,which can also be used to assess the progression of gastric adenocarcinoma.

国家自然科学基金资助项目（No. 81272696）；山西省人才专项项目（No. 201705D211021）；山西省重点研发计划项目（No.201903D321027）