胃癌患者外周血细胞游离核酸标志物的检测和应用  

Detection and application of cell-free nucleic acid biomarkers for diagnosis of gastric cancer

作　　者：周韵斓[1] 窦敏[1] 杨蓉[1] 杨明[2] 

机构地区：[1]上海交通大学医学院附属新华医院检验科,上海200092 [2]上海交通大学医学院附属新华医院肛肠外科,上海200092

出　　处：《诊断学理论与实践》2013年第1期57-61,共5页Journal of Diagnostics Concepts & Practice

摘　　要：目的:分析并评价10种外周血细胞游离核酸标志物在胃癌诊断中的应用价值。方法:提取胃癌患者及健康对照者的血清总RNA,反转录后采用实时荧光聚合酶链反应对候选基因进行检测,同时采用电化学发光免疫分析法检测癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、CA724,并运用Logistic回归及受试者工作特征(ROC)曲线对标志物进行分析。结果:胃癌患者血清中TP73(DNp73α)及肝细胞生长因子受体c-MET表达量较健康对照者显著增高(P<0.05)。c-MET检测对胃癌诊断的灵敏度为65.5%,特异度为76.4%,曲线下面积(AUC)为0.73,与TP73(DNp73α)比较,两者间的AUC差异有统计学意义(P<0.05)。c-MET与CEA、CA199、CA724联合检测时,其诊断灵敏度为75.0%,特异度为87.3%,AUC为0.83;与仅CEA、CA199、CA724三者联合检测相比,AUC差异有统计学意义(P<0.05)。不同肿瘤转移情况、不同TNM分期的患者,其c-MET表达量明显不同(P<0.05)。结论:检测外周血c-MET表达在胃癌诊断中具有一定价值,可作为临床常用胃癌肿瘤标志物的补充。Objective To analyze and evaluate the clinical application of ten cell-free nucleic acid biomarkers for diagnosis of gastric cancer. Methods Total RNA was extracted and purified from serum of both gastric cancer patients and healthy volunteers, and was submitted to real-time quantitative PCR for amplification after being reversely transcripted. Carcinoembryonic antigen （CEA）, carbohydrate antigen 19-9 （CA19-9） and carbohydrate antigen 724 （CA724） were detected by electrochemiluminescence immunoassay analyzer. The receiver operating characteristic （ROC） curves established by Logistic regression analysis were evaluated for those biomarkers. Results Patients of gastric cancer had elevated TP73 （DNp73α） and c-MET expression than healthy volunteers （P〈0.05）. The diagnostic sensitivity, specificity and area under curve （AUC） of c-MET was 65.5%, 76.4% and 0.73, respectively. There was significant difference in AUC between c-MET and TP73 （DNp73α ）（P〈0.05）. The diagnostic performances were improved by combining c-MET with CEA, CA19-9 and CA724, the sensitivity, specificity and AUC were 75.0%, 87.3%, and 0.83, respectively. AUC of combining the four biomarkers was significantly higher than combing the latter three （P〈0.05）. Patients with different metastatic condition and TNM staging showed significant difference in c-MET expression （P〈0.05）. Conclusions Quantification of cell-free c-MET has diagnostic value for gastric cancer, and could be applied to supplement the currently used tumor markers.

关 键 词：胃癌细胞 细胞游离核酸 癌胚抗原 糖类抗原19 9 肝细胞生长因子受体c-MET 

分 类 号：R735.2[医药卫生—肿瘤]