大肠癌患者血清中巨噬细胞抑制因子-1升高的临床价值研究  

Application of serum macrophage inhibitory cytokine-1 in colorectal cancer

作　　者：王小兵[1] 付超[2] 田海梅[1] 李艳芬[1] 李茉[1] 程冬婉[1] 常青云[1] 刘珊[1] 齐军[2] 张伟 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院生物检测中心,北京100021 [2]中国医学科学院北京协和医学院肿瘤医院检验科,北京100021

出　　处：《癌症进展》2011年第4期374-378,373,共6页Oncology Progress

基　　金：国家高技术研究发展863计划资助项目(项目编号:2008AA02Z415)

摘　　要：目的探讨巨噬细胞抑制因子1(MIC-1)在大肠癌诊断和早期诊断、治疗监测及复发预警中的临床价值。方法应用自主研制的MIC-1检测试剂盒检测239例不同临床分期的大肠癌患者、16例肠道良性疾病患者及200例健康人血清样本中MIC-1水平,并对部分肿瘤患者进行连续监测;应用罗氏Cobas 601电化学发光免疫分析仪检测上述样品中的CEA和CA19-9水平并与MIC-1检测结果进行比较。结果大肠癌患者组MIC-1血清水平显著高于良性疾病组和正常对照(分别为1138.16±857.46、486.76±220.93、391.56±299.55,P<0.001);不同临床分期大肠癌患者血清中MIC-1水平呈递增趋势;MIC-1在早期大肠癌患者(Ⅰ期和Ⅱ期)中显示出良好的诊断敏感性,远优于CEA(Ⅰ期:28.0%vs8.0%;Ⅱ期:42.7%vs34.7%),提示MIC-1的早期诊断价值优于CEA;MIC-1与CEA联合检测,可由原来CEA42.3%的灵敏度提高至64.4%,显著优于MIC-1、CEA和CA19-9单独检测;MIC-1血清水平在有效治疗后显著下降(P<0.001),复发转移时MIC-1水平显著升高(P<0.001)。结论研究结果明确显示MIC-1是大肠癌有价值的新血清肿瘤生物标志物,对于提高大肠癌的诊断和早期诊断水平以及反映临床疗效具有重要的临床意义和价值。Objective To investigate the clinical value of macrophage inhibitory cytokine-1 （MIC-1） in diagnosis, early diagnosis, treatment monitoring and recurrence warning of colorectal cancer. Methods Serum samples form 239 patients with different clinical stages of colorectal cancer, 16 patients with benign bowel disease and 200 healthy human were detected by self-made MIC-1 assay kit for MIC-1 level. And some of tumor patients are followed up. CEA and CA19- 9 were analyzed by Roche Cobas 601 ECL analyzer. Results MIC-1 level in colorectal cancer patients was significantly higher than that in benign disease patients and normal control （ 1138.16 ± 857.46, 486. 76 ±220. 93, 391.56 ±299. 55, P 〈0. 001 ）. Serum levels of MIC-1 showed an increasing trend in different clinical stages of colorectal cancer. MIC-1 have more sensitivity than CEA in patients with early colorectal cancer （ stage Ⅰ ： 28. 0% vs 8. 0% ; stage Ⅱ ： 42. 7% vs 34. 7% ）. Combined detection of CEA and MIC-I increased the sensitivity from 42. 3% of CEA to 64. 4%, which was significantly better than the detection of MIC-1, CEA and CA19-9 alone. Serum levels of MIC-1 decreased sig- nificantly after effective treatment （P 〈 0. 001 ） , and significantly increased at recurrence （P 〈 0. 001 ）. Conclusion MIC-1 is a new and effective colorectal cancer biomarker in serum for the diagnosis of colorectal cancer, it is valuable in improving early diagnosis and monitoring clinical response.

关 键 词：巨噬细胞抑制因子-1 肿瘤标志物大肠癌临床价值 

分 类 号：B392-33[哲学宗教—外国哲学] R735.34[医药卫生—肿瘤]