巨噬细胞抑制因子-1联合多种标志物在结直肠癌诊断中的价值研究  

Application of macrophages inhibitory cytokine-1 combined with multiple biomarkers in the diagnosis of colorectal cancer

作　　者：赵文雅[1] 王小兵[1] 田海梅[1] 李艳芬[1] 李茉[1] 张超[1] 沈迪[2] 齐军[2] 张伟[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院/肿瘤研究所生物检测中心,北京100021 [2]北京协和医学院中国医学科学院肿瘤医院/肿瘤研究所检验科,北京100021

出　　处：《癌症进展》2014年第3期291-297,共7页Oncology Progress

基　　金：国家高技术研究发展计划(863计划)课题(2008AA02Z415)

摘　　要：目的研究巨噬细胞抑制因子1(MIC-1)在结直肠癌诊断和早期诊断中的价值,并探讨多种标志物联合应用于检测结直肠癌的可行性。方法应用自主研制的MIC-1定量检测试剂盒及Roche Cobas 601电化学发光免疫分析仪分别检测429例不同临床分期的结直肠癌患者和129例健康人血清样本中的MIC-1、CA19-9、CEA和TPS水平,比较MIC-1水平与其他肿瘤标志物的关系、与患者TNM分期的关系,以及在结直肠癌诊断和早期诊断中的价值。结果结直肠癌患者血清中的MIC-1水平显著高于正常对照人群(1045.88±892.67 vs 398.04±263.19,P<0.001);肿瘤患者血清MIC-1水平随肿瘤浸润深度(T分期)增加而升高(P=0.001),并与淋巴结转移(N分期,P=0.007)和远端转移显著正相关(P<0.001);MIC-1、CEA和TPS三种标志物联合检测早期结直肠癌检测敏感性可达61.3%,显著高于CEA的检出率(25.6%)。结论 MIC-1是结直肠癌尤其是早期结直肠癌有价值的血清肿瘤标志物,MIC-1、CEA和TPS联合检测对于提高结直肠癌的早期诊断率具有重要的临床意义和价值。Objective To study the value of macrophages inhibitory cytokine-1 （MIC-1） in the diagnosis of colorectal cancer, especially for early stage colorectal cancer. To explore the feasibility of the early detection by a combination of multiple biomarkers including MIC- 1 in colorectal cancer patients. Method Serum samples were collected from 429 patients with different TNM phases of colorectal cancer and 129 healthy controls, The serum level of MIC-1, CA19-9, CEA and TPS were detected by self-developed MIC-I double antibody sandwich ELISA Kit and Roche Cobas 601 ECL analyzer, respectively. The level of serum MIC-1 was evaluated in different stages of TNM, and compared with other biomarkers to define the value of MIC- 1 in the diagnosis and early diagnosis of colorectal cancer. Result The serum level of MIC- 1 in colorectal cancer is significantly higher than that of controls, （ 1045.88±892.67 pg/ml vs 398.04±263.19 pg/ml; P〈 0. 001 ）. A stepwise increase of MIC-1 level was noted in patients with the progress of disease, and positively correlated with the depth of tumor invasion （P= 0. 001 ）, lymph node metastasis （ P = 0. 007 ） and remote metastasis （ P〈 0. 001 ）. The results also showed that the combination of MIC-1, CEA and TPS has a sensitivity of 61.3%, which was significantly higher than that of CEA （ 25.6% ）, that was commonly used in clinical settings. Conclusion MIC-1 is a valuable biomarker of colorectal cancer, especially for detection of early stage colorectal cancer. There is important clinical value for MIC-1 combined with CEA and TPS in early detection of colorectal cancer.

关 键 词：结直肠癌 巨噬细胞抑制因子-1 癌胚抗原 组织多肽特异性抗原 联合检测 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]