TK1、HSP90α联合CEA、CA199检测在结直肠癌临床诊断中的意义  

Clinical Significance and Diagnostic Capacity of TK1,HSP90α Combined with CEA,CA199 in Colorectal Cancer Patients

作　　者：刘媛芳[1] 利基林 梁新强[1] 谢丽叶 蔡政民[1] 黄怡[1] LIU Yuan-fang;LI Ji-lin;LIANG Xin-qiang;XIE Li-ye;CAI Zheng-min;HUANG Yi(Tumor Hospital Affiliated to Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院,广西南宁530021

出　　处：《药物生物技术》2019年第6期498-501,共4页Pharmaceutical Biotechnology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(No.Z20190637);广西医科大学教师教学能力发展项目[桂医大教评(2019)6号]。

摘　　要：探讨胸苷激酶TK1和热休克蛋白HSP90α联合CEA、CA199检测在结直肠癌患者临床诊断中的意义。选取该院接收符合手术治疗的直肠癌患者147例,另选取30例健康体检者为正常对照组,采用酶联免疫吸附法测定血清TK1和血浆HSP90α,以电化学发光法检测血清CEA、CA199。联合临床病理分析通过联合检测分析两者与结直肠癌(CRC)临床病理特征之间的关系,绘制ROC曲线分析联合检测方案对结直肠癌的诊断效能。与正常对照组比较,CRC血清TK1、HSP90α、CEA、CA199水平均有所升高,差异均有统计学意义,P <0. 05。CRC组TK1、HSP90α水平与患者性别、年龄无关,P> 0. 05,但与治疗效果相关,P <0. 05。TNM分期Ⅰ+Ⅱ期患者TK1、HSP90α水平低于Ⅲ+Ⅳ期患者,差异有统计学意义,P <0. 05。TK1表达与HSP90α(r=0. 108,P <0. 05)、CEA(r=0. 100,P <0. 05)、CA199 (r=0. 308,P <0. 05)表达相关;HSP90α表达与CEA (r=0. 144,P <0. 05)、CA199(r=0. 216,P <0. 05)表达相关。单项检测诊断效能分析显示,ROC曲线下面积AUC:TK1 (0. 904)>HSP90α(0. 862)> CA199(0. 849)> CEA(0. 798),其中TK1单项检测的诊断效能最高。TK1、HSP90α联合CEA、CA199检测提高了CRC临床诊断的敏感度和检出率,同时对CRC治疗效果具有一定的指导意义。To explore the clinical significance and diagnostic capacity of TK1,HSP90α combined with CEA,CA199 in colorectal cancer patients,147 colorectal cancer patients were admitted and treated by surgery in the auther’s hospital as the colorectal cancer group. And 30 healthy people were selected as the normal control group. Serum TK1 and plasma HSP90α were determined by enzyme-linked immunosorbent assay( ELISA),and serum CEA,CA199 were detected by electrochemiluminescence. The ROC curve was analyzed for the clinical significance and diagnosis in colorectal cancer,which provided new evidence for improving the sensitivity of diagnosis of colorectal cancer. The TK1,HSP90α concentration was significantly higher in patients with cancer than in healthy controls and patients with clinical stage III + IV had higher TK1,HSP9α levels than clinical stage I + II( P < 0. 05). The levels of TK1 and HSP90α was significantly associated with tumor stage and treatment effect( P < 0. 05),but was not related to gender and age( P >0. 05). TK1,HSP9α levels of TNM stageⅢ +Ⅳ patients were higher than stage I + II patients( P <0. 05). The expression of TK1 was correlated with the expression of HSP90α( R = 0. 108,P < 0. 05),CEA( R = 0. 100,P < 0. 05) and CA199( R = 0. 308,P < 0. 05).The expression of HSP90α was correlated with the expression of CEA( R = 0. 144,P < 0. 05) and CA199( R = 0. 216,P < 0. 05). The diagnostic efficacy analysis of single detection showed that AUC under ROC curve was TK1( 0. 904) > hsp90 a( 0. 862) > CA199( 0. 849) > CEA( 0. 798),among which single detection of TK1 had the highest diagnostic efficacy. The detection of TK1,HSP90αcombined with CEA and CA199 improved the sensitivity and detection rate of clinical diagnosis in colorectal cancer,which had a certain guiding significance for the treatment effect of colorectal cancer with high clinical application value.

关 键 词：结直肠癌 胸苷激酶 热休克蛋白90Α 联合检测 敏感度 治疗效果 

分 类 号：R446.112[医药卫生—诊断学] R735.37[医药卫生—临床医学]