肿瘤标志物蛋白芯片中胃肠道恶性肿瘤相关指标的筛选优化  

Screening and Optimizing the Gastrointestinal Cancer Related Tumor Markers from Multi-Tumor Markers Proteinchip

作　　者：侯晋轩[1] 杨雪琴[1] 陈创[1] 江桥[2] 杨国梁[1] 李雁[1] 

机构地区：[1]武汉大学中南医院肿瘤科/肿瘤生物学行为湖北省重点实验室/湖北省肿瘤医学临床研究中心,湖北武汉430071 [2]武汉大学中南医院检验科/肿瘤生物学行为湖北省重点实验室/湖北省肿瘤医学临床研究中心,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2008年第5期602-606,共5页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:20675058);国家自然科学基金创新群体资助项目(编号:20621502);教育部新世纪优秀人才支持计划(编号:NCET-04-0669);全国优秀博士学位论文作者专项资金资助项目(编号:200464);湖北省青年杰出人才基金资助项目(编号:301161202)

摘　　要：目的:分析C12多肿瘤标志物蛋白芯片指标与胃肠道恶性肿瘤的相关性,筛选相关指标,为建立胃肠道恶性肿瘤小型诊断芯片提供依据。方法:使用C12多肿瘤标志物蛋白芯片系统,检测156例胃癌患者与173例结直肠癌患者术前血清中12种常见肿瘤标志物(CA19-9、NSE、CEA、CA242、CA125、CA15-3、AFP、FER、free-PSA、PSA、β-HCG及HGH)的水平,筛选出胃肠道恶性肿瘤相关指标,采用Kappa检验比较其与C12检测结果的一致性,并用成本-效果分析方法,寻找最佳组合。结果:329例胃肠道恶性肿瘤患者肿瘤标志物升高主要集中在4项指标:CEA(27.4%)、CA242(19.8%)、CA19-9(19.5%)、CA125(8.5%);使用Kappa检验比较4项指标不同组合与C12的检测结果,得出一致性极强的小型组合有6种,使用成本-效果分析法得出最佳组合为CA19-9+CEA。结论:C12多肿瘤标志物蛋白芯片系统对胃肠道恶性肿瘤的辅助诊断有一定的临床价值,但芯片设计复杂、成本较高,不利于普遍开展高危人群筛查,难以及时、实时监测病人的病情变化。因此,有必要在该芯片基础上,筛选胃肠道恶性肿瘤相关指标,设计小型芯片,在不降低检出率的情况下,增强其实际临床应用价值。Objective： To analyze the association between C12 tumor markers and gastrointestinal cancer, in order to screen for gastrointestinal cancer related tumor markers so as to provide theoretical basis for the establishment of gastrointestinal cancer diagnostic biochips. Methods. The sera of 156 gastric cancer and 173 eolorectal cancer patients were detected for 12 common tumor markers including carcinoembryonic antigen （CEA）, alpha-fetoprotein （AFP）, carbohydrate antigen 19-9 （CA19-9）, carbohydrate antigen 242 （CA242）, cancer antigen 15-3 （CA15 3）, cancer antigen 125 （CA125）, prostate specific antigen （PSA）, free-PSA, neuron-specific enolase （NSE）, hu- man chorionic gonagotropin-beta （β-HCG）, human growth hormone （HGH） and ferritin using the C12 tumor markers proteinchip, and gastrointestinal cancer related parameters were analyzed by Kappa test and cost effectiveness analysis to find the most optimal tumor marker combination. Results： CEA （27.4%）, CA242 （19.8%）, CA19 9（19.5%）, CA125（8.5%） were major tumor markers increased among the 329 gastrointestinal cancer patients. Kappa test revealed six tumor marker combinations having strong consistency with the detection results of C12 tumor markers proteinchip, and CEA plus CA19 9 proved to be the best combination by cost-effectiveness analysis. Conclusion： C12 tumor markers proteinchip system had some value in the diagnosis of gastro- intestinal cancer, but the design of chip was too complicated and costly for widespread screening among the high risk populations. Searching for new gastrointestinal cancer biomarkers and desig ning small diagnostic chip could significantly enhance the clinical value of tumor markers in terms of diagnostic rate and practical utility.

关 键 词：肿瘤标志物 胃肠道恶性肿瘤 蛋白芯片 小型化 

分 类 号：R730.4[医药卫生—肿瘤]