结直肠癌患者血浆YKL-40和CEA联合检测的临床意义  

Detection of plasma YKL-40 and CEA in colorectal cancer and their clinical significance

作　　者：叶辉铭[1,2] 林永志[1,2] 刘莉莉[1,2] 张忠英[1,2] 

机构地区：[1]厦门大学附属中山医院临床检验中心 [2]厦门市临床检验中心,福建厦门361004

出　　处：《国际检验医学杂志》2011年第3期317-319,共3页International Journal of Laboratory Medicine

基　　金：福建省自然基金(2009D005)

摘　　要：目的探讨血浆YKL-40、癌胚抗原(CEA)、糖类抗原(CA199)单项和联合检测在结直肠癌辅助诊断和复发监测中的应用价值。方法应用ELISA法和ECLIA法检测120例结直肠癌患者的血浆YKL-40、CEA和CA199,以43例良性肠道疾病患者和36例健康体检者为对照;分析血浆YKL-40与肿瘤临床病理指标的关系;评价结直肠癌患者血浆YKL-40、CEA、CA199单项及联合检测的阳性率和诊断效率。结果癌症组血浆YKL-40显著高于良性对照组和健康对照组,差异有统计学意义(P<0.05);YKL-40对结直肠癌的诊断敏感度和特异度分别为73.2%和66.7%。初发结直肠癌患者血浆YKL-40阳性率显著高于CEA和CA199(P<0.05);YKL-40与CEA联合、YKL-40与CA199联合的阳性率分别为82.1%和80.3%。术后复发组对术后未复发组的ROC曲线分析,YKL-40、CEA和CA199的曲线下面积分别为0.907、0.714和0.759,YKL-40与后两者比较P均小于0.05。随着结直肠癌疾病进展,血浆YKL-40水平逐渐升高,肿瘤分化程度越低,YKL-40水平越高。结论 YKL-40对结直肠癌复发监测的价值高于CEA和CA199;联合检测YKL-40和CEA对结直肠癌有较好的辅助诊断价值。Objective YKL 40 has been previously described;as a prognostic and diagnostic marker for a number of epithelial cancers. In this study, we compared YKL 40 with two colorectal cancer serum markers, CEA and CA199, for the clinical significance for colorectal cancer. Methods Plasma YKL-40 levels were assayed by enzyme-linked immunosorbent assay （EIA）, CEA and CA199 levels were assayed by electro-chemiluminescence immuno assay（ECLIA）. The samples were taken from 120 colorectal cancer patients（56 preoperation, 22 recurrent and 42 postoperation） ,43 patients with benign colorectal diseases, and 36 healthy subjects. Then we analyzed YKL-40rs correlation to six elinicopathologic parameters,and also compared YKL-40 with CEA and CA199 in colorectal cancer. Results Mean YKL-40 level was 145.4,107.7 and 51.3 ng/mL for colorectal cancer, benign colorectal diseases and healthy subjects respectively（P〈0.05）. The YKL-40 cutoff value for colorectal cancer was 72 ng/mL,its sensitivity and speci- ficity were 73.2% and 66.7%respectively. The positive rate for YKL-40,CEA and CA199 in preoperation coloreetal cancer were 73 %,50% and 32%,respectively（P〈0.05）. Area under receiver operating characteristics curves of YKL-40, CEA and CA199 in recurrent colorectal cancer compared with postoperation colorectal cancer patients were 0. 907,0. 714 and 0. 759, respectively. Mean YKL-40 level was 120.1,131.7 and 226.8 ng/mL for Dukers A/B, Duke＇s C and Dukers D, respectively（ P=0. 008）. Mean YKL-40 level was 196.8,127.5 and 225.7 ng/mL for Grade 1 ,Grade 2 and Grade 3 respectively（P= 0. 004）. Conclusion YKL-40 may represent a novel marker for the detection of colorectal cancer. YKL-40 levels in postoperation patients may better predict disease re currence than CEA and CA199. YKL-40 may play a role in tumor invasiveness and metastasis,but more research is required.

关 键 词：结直肠肿瘤 肿瘤侵润 复发 YKL-40蛋白 

分 类 号：R735.3[医药卫生—肿瘤]