血清标记物联合检测诊断结直肠癌转移的意义  

Clinical Significance of Combined Diagnostic Tests of Serum Markers in Detecting Metastasis Colorectal Cancer

作　　者：陈勇[1] 王志明[1] 金文[1] 周宇红[1] 庄荣源[1] 宋燕[1] 冯艺[1] 李倩[1] 刘天舒[1] 

机构地区：[1]复旦大学附属中山医院肿瘤内科,上海200032

出　　处：《中国临床医学》2009年第1期94-96,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨血清血管内皮生长因子(VEGF)、骨桥蛋白(OPN)与CA19-9、CEA检测诊断结直肠癌转移的意义。方法:测定76例结直肠癌患者(其中51例为转移性结直肠癌,25例为术后无转移者)血清中的VEGF、OPN和CA19-9及CEA水平,分析这些指标诊断结直肠癌转移的临床意义。结果:转移性结直肠癌组(51例)和术后无转移病灶组(25例)VEGF平均水平分别为698.3±221.5pg·mL-1和547.5±183.6pg·mL-1(P<0.01);OPN水平分别为191.7±78.3ng·mL-1和91.3±34.0ng·mL-1(P<0.01);血清中CEA平均水平分别为97.8±239.6ng·mL-1和4.8±6.2ng·mL-1(P<0.01),CA19-9平均水平分别为230.8±704.0μg·mL-1和11.6±14.8μg·mL-1(P=0.03)。OPN和CEA在诊断结直肠癌转移方面准确度较高(分别为77.63%和61.84%),该两项标记物平行试验,可提高转移性结直肠癌的诊断敏感性(84.31%)和诊断的特异度(96%)。结论:血清OPN与CEA联合检测对转移性结直肠癌的诊断有较大的临床意义,可为结直肠癌转移的诊断提供参考性指标。Objective： To investigate the clinical significance of combined detection of serum VEGF （vascular endothelial growth factor）, OPN （Osteopontin）, CA19-9 and CEA levels in diagnosis of metastasis colorectal cancer. Methods：76 patients with colorectal cancer were collected in our department. They were divided into two groups, patients with metastases（MCRC, N = 51 ） and patients after eradicative operation（non-metastasis group, NM,N = 25）. Serum markers of VEGF, OPN, CA19-9 and CEA were detected in all the included patients, and then to analyze the diagnostic value of the serum markers in detection of metastases. Results：Serum VEGF levels were 698.3 ± 221.5pg · ml^-1 in MCRC group and 547.5 ± 183.6 pg · mL ^-1 in NM group（P〈0.01） ,Serum OPN levels were 191.7 ± 78.3ng · mL ^-1 and 91.3 ± 34.0 ng · mL ^-1 respectively （P〈0.01）. Serum CEA levels were 97.8 ± 239.6 ng · mL ^-1and 4.8 ± 6.2 ng · mL ^-1 respectively （P〈0.01） and serum CA19-9 levels were 230.8±704.0 μg· mL ^-1 and 11.6±14.8 μg· mL ^-1 respectively （P=0.03）. OPN andCEA showed higher degree of accuracy of metastases than CA19-9 and VEGF. The degree of accuracy of OPN and CEA were 77.63% and 61.84% respectively, Combined parallel tests with OPN and CEA could improve the sensitivity up to 84. 31%, and combined serial tests with OPN and CEA could improve the specificity up to 96%. Conclusions： Combined detection of serum markers OPN and CEA can give help to diagnose the metastasis colorectal cancer.

关 键 词：结直肠癌 转移 血清标记物 诊断 

分 类 号：R735.3[医药卫生—肿瘤]