MIC-1及其多标志物联合对肠癌诊断分析  

Clinical significance of tumor markers combined detection in the diagnosis of colorectal cancer

作　　者：宋炳红[1] 徐岩 孙运军 张超[3] 王腾[3] 李茉[3] 田海梅[3] 李艳芬[3] 王小兵[3] 赵文雅 张伟[3] SONG Bing-hong XU Yan SUN Yun-jun ZHANG Chao WANG Teng LI Mo TIAN Hai-mei LI Yan-fen WANG Xiao-bing ZHAO Wen-ya ZHANG Wei(Linyi People＇s Hospital of Shandong University ,Linyi 276000 ,P. R. China Linyi Cancer Hospital of Shandong Province, Linyi 276001, P. R. China Biological testing center of cancer hospital of Chinese academy of medical sciences ,Beijing 100021 ,P. R. China)

机构地区：[1]临沂市人民医院体检中心,山东临沂276000 [2]临沂市肿瘤医院体检中心,山东临沂276001 [3]中国医学科学院肿瘤医院生物检测中心,北京100021

出　　处：《中华肿瘤防治杂志》2017年第17期1223-1227,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的巨噬细胞抑制因子-1(macrophages inhibitory cytokine-1,MIC-1)是近年来发现的一个广谱肿瘤标志物,广泛参与细胞凋亡、侵袭及转移等生物学过程。本研究旨在研究MIC-1在肠癌诊断中的价值,并探讨MIC-1、CA19-9和CEA多标志物联合用于肠癌检测可行性。方法选取2011-01-01-2014-12-30中国医学科学院肿瘤医院收治肠癌患者162例作为肠癌组,另选取同期300名健康体检者作为对照组。采用定量检测试剂盒分别检测162例不同临床分期未治疗肠癌患者和300名正常人群血清样本中的MIC-1、CA19-9和CEA水平,比较MIC-1与其他标志物、肿瘤患者临床分期的关系,以及在肠癌诊断与早期诊断的应用价值。结果肠癌患者血清MIC-1水平高于正常人群,P<0.001;且随临床分期进展呈上升趋势,并与TNM分期和患病部位呈现相关性,均P值<0.05。MIC-1诊断敏感性为53.7%,高于CA19-9(10.5%)和CEA(30.2%)。3种标志物联合检测敏感性为67.9%,MIC-1与CEA联合检测敏感性为66.7%。Logistic回归分析发现,肠癌诊断与MIC-1和CEA有关(P<0.001,P<0.05),回归方程转化的预测概率值ROC曲线AUC=0.915,约登指数最大为0.656,敏感性为92.6%,特异性为73.0%。结论 MIC-1对肠癌诊断具有重要临床辅助价值,多标志物联合联合检测能大幅提高诊断敏感性,适于正常人体检以及肠癌患者早期诊断。OBJECTIVE Macrophage inhibitory cytokine-1 （MIC-1） is a broad spectrum tumor marker which was discovered in recent years,and it was widely involved in biological processes such as apoptosis,invasion and metastasis. This paper aimed to study the value of MIC1 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. METHODS From January 2011 to December 2014,162 colorectal cancer patients were treated in the Cancer Hospital of Chinese Academy of Medical Sciences, and 300 cases of healthy people in the same period as control group. The levels and distribution of MIC-1 ,CA19-9 and CEA in serum samples from 162 untreated patients with different clinical stages of colorectal cancer and 300 healthy subjects were analyzed,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. RESULTS The serum levels of MIC-1 in patients with colorectal cancer were significantly higher than those in healthy control （P〈0. 001）. A stepwise increase of MIC 1 levels was noted with the progress of colorectal cancer （P〈0. 001）, and the levels were correlated with T, N, M stage and the location of colorectal cancer （all P〈0.05）. The sensitivity of MIC-1（53.7%） was superior to CA19-9（10.5%） and CEA （30.2%）. The sensitivities of MIC-1 were high in early stage colorectal cancer （33.3 %, 54.9 %）. The sensitivity of the combined three biomarkers was up to 67.9%. Notably,the sensitivity of the combination of MIC1 and CEA was 66.7% ,close to that of the combined three biomarkers. The results of logistic regression showed that the detection of eolorectal cancer was correlated with MIC-1 and CEA （P〈0. 001 ,P〈0.05）. The AUC of ROC curve of probability values reckoned by the regression equation was 0.91

关 键 词：肠癌 巨噬细胞抑制因子-1 联合检测 早期诊断 

分 类 号：R735.3[医药卫生—肿瘤]