血清卷曲螺旋蛋白49及胃动蛋白2诊断胃癌的临床价值  

Clinical value of serum CCDC49 and GKN2 in diagnosis of gastric cancer

作　　者：徐小虹[1,2] 李建芳[1] 苏丽萍[1] 李琛[1] 朱正纲[1] 刘炳亚[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院上海消化外科研究所上海市胃肿瘤重点实验室,上海200025 [2]上海市嘉定区中心医院外科,上海201800

出　　处：《外科理论与实践》2015年第3期226-231,共6页Journal of Surgery Concepts & Practice

摘　　要：目的 ：探讨血清卷曲螺旋蛋白49（CCDC49）及胃动蛋白2（GKN2）对胃癌诊断的临床价值。方法 ：应用ELISA检测205例胃癌组、96例癌前病变组及94例正常对照组共395例血清样本中CCDC49及GKN2的表达水平,结果以中位数和四分位数间距表示,并对结果进行统计学分析,以ROC曲线下面积（ROC-AUC）评价诊断的准确性。结果：胃癌组血清CCDC49表达水平高于正常对照组及癌前病变组（P〈0.05）。血清CCDC49的AUC为0.69,95%CI：0.64-0.74。血清CCDC49取临界值为83.0 pg/m L时,CCDC49诊断胃癌的灵敏度和特异度分别为81.5%（167/205）和51.6%（98/190）。胃癌组血清GKN2表达水平低于正常对照组及癌前病变组（P均〈0.05）。血清GKN2的AUC为0.77,95%CI：0.72-0.82。血清GKN2取临界值为93.2 pg/m L时,GKN2诊断胃癌的灵敏度和特异度分别为77.1%（158/205）和65.8%（125/190）。用Logistic回归方程求出CCDC49和GKN2联合预测因子Y,Y的AUC为0.88,95%CI：0.85-0.92,当Y取临界值为2.4时,其诊断胃癌的灵敏度和特异度为84.9%（174/205）和65.8%（125/190）。结论 ：血清CCDC49的高表达水平及GKN2的低表达水平对胃癌具有一定的诊断价值,CCDC49和GKN2联合预测因子Y可作为一种新的、较好的胃癌诊断参考指标。Objective To explore the clinical value of serum coiled-coil domain containing protein 49（CCDC49） and gastrokine 2（GKN2） in the diagnosis of gastric cancer. Methods The serum sample from 395 individuals were collected including 205 patients with gastric cancer, 96 patients with precancerous lesions and 94 healthy controls. The levels of CCDC49 and GKN2 in the serum were detected by ELISA. The results were showed as both median and inter-quartile.The accuracy of diagnosis was evaluated by area under the curve（AUC）. Results The expression of CCDC49 in serum of the patients with gastric cancer was significantly higher than that of precancerous lesions and healthy groups（ P〈0.05）. The AUC of CCDC49 for gastric cancer diagnosis was 0.69（95%CI： 0.64-0.74）. When the cut-off was determined as 83.0 pg/m L,the sensitivity and specificity of CCDC49 for gastric cancer diagnosis were 81.5%（167/205） and 51.6%（98/190）respectively. However, the expression of serum GKN2 in the patients with gastric cancer was lower significantly than that of precancerous and healthy groups（P〈0.05）. The AUC of GKN2 for gastric cancer diagnosis was 0.77（95%CI： 0.72-0.82）.The sensitivity and specificity of GKN2 for gastric cancer diagnosis were 77.1%（158/205）and 65.8%（125/190）respectively setting the cut-off 93.2 pg/m L. The factor of combined predicting gastric cancer was gotten with Logistic regression. AUC of Y was 0.88（95%CI： 0.85-0.92）. The sensitivity was 84.9%（174/205） and specificity 65.8%（125/190）when setting the cut-off 2.4. Conclusions The higher expression of serum CCDC49 and lower expression of serum GKN2 should have a suggestion for diagnosis of gastric cancer. The factor of combined prediction Y might be a reference of diagnosis.

关 键 词：卷曲螺旋蛋白49 胃动蛋白2 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]