胃癌患者血清CRP、IL-6和典型肿瘤标志物检测临床诊断意义分析  

Detection of serum CRP,IL-6,and classic tumor markers and evaluation of the clinical significance

作　　者：姚尚彦[1] 曹鸿挺[1] 杨晓扬[1] 

机构地区：[1]解放军第421医院检验输血科,广东广州510318

出　　处：《中国实验诊断学》2015年第3期376-379,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨血清CRP和IL-6检测与胃癌临床特征的相关性,并分析其临床诊断中的意义。方法收集92例胃癌患者,70例健康对照。治疗前抽取血样,利用酶联免疫法(euzymelinked immunosorbent assay,ELISA)检测IL-6,利用免疫比浊法检测CRP,用微粒子免疫法(microparticle enzyme immunoassay,MEIA)测定CEA和CA19-9。将患者根据TNM分期、胃壁侵润程度、淋巴结受累数量、远端转移进行分组。两组间各蛋白浓度的比较采用MannWhitney U检验,三组以上的数据比较采用单向ANOVA Kruskal-Wallis检验,对各分组间各蛋白血清浓度进行对比分析。同时,计算评价各蛋白检测的诊断敏感性与特异性,阴性与阳性预测值。结果患者血清CRP、IL-6、CEA和CA19-9与健康对照间均有显著差异(P<0.001),且与肿瘤分期、胃壁侵润度、淋巴结转移数和远端转移相关,肿瘤不可切除患者血清CRP、IL-6和CA19-9浓度高于肿瘤可切除患者,但是差异无显著性。四种蛋白诊断敏感性和阴性预测值为IL-6>CRP>CA19-9>CEA,而且IL-6与CRP或CEA结合的敏感性均显著增加;诊断特异性和阳性预测值依次为CEA=CA19-9>CRP>IL-6。结论血清IL-6和CRP检测在胃癌诊断中可能有重要意义,值得进一步研究。Objective To investigate the correlation between serum CRP,IL-6levels and clinical features of gastric carcinoma（GC）,and evaluate the diagnostic significance of the proteins.Methods A total of 92 cases of GC and 70 healthy individuals were enrolled in the study,blood samples were collected before treatment,euzymelinked immunosorbent assay（ELISA）was used to detect the IL-6,immunoturbidimetry was used to detect CRP,microparticle enzyme immunoassay（MEIA）was used to detect CEA and CA19-9in the sera.The cases were subdivided into several subgroups according to the tumor stage,gastric wall invasion,nodal involvement,and presence of distant metastasis.MannWhitney U-test and one-way ANOVA Kruskal-Wallis test were performed for the comparisons between two groups and three groups or more respectively.Moreover,diagnostic sensitivity and specificity,negative and positive predictive values of the four proteins were evaluated.Results Sera CRP,IL-6,CEA and CA19-9in GC patients were statistically higher than those in healthy subjects,and were correlated with the tumor stage,gastric wall invasion,lymph nodes metastases,and distant metastases.Furthermore,the serum concentrations of CRP,IL-6,and CA19-9of the patients with nonresectable tumors were higher than those of the patients with resectable tumors,although these differences were not significant.The diagnostic sensitivity and negative predictive value of all tested proteins were ranked as IL-6〉CRP〉CA19-9〉CEA,moreover,and the diagnostic sensitivity was increased for the combination of IL-6with CRP or CEA;the diagnostic specificity and positive predictive value of the proteins were ranked as CEA=CA19-9〉CRP〉IL-6.Conclusion Serum IL-6and CRP determinations might be valuable in GC diagnosis,further investigation is necessary.

关 键 词：胃癌 C反应蛋白 白细胞介素-6 典型肿瘤标志物 临床诊断 

分 类 号：R735.2[医药卫生—肿瘤]