可溶性ST2在结直肠癌中的表达及临床意义  

Expression and clinical significance of soluble ST2 in colorectal cancer

作　　者：王洁 张广慧[2] 杨蓉[2] 杜坤[2] WANG Jie;ZHANG Guanghui;YANG Rong;DU Kun(Department of Clinical Laboratory,Shanghai Ruijin Rehabilitation Hospital,Shanghai 200023,China;Department of Laboratory Medicine,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海市瑞金康复医院检验科,上海200023 [2]上海交通大学医学院附属新华医院检验科,上海200092

出　　处：《国际检验医学杂志》2020年第19期2384-2387,2391,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨可溶性ST2(sST2)在结直肠癌中的表达情况及其与肿瘤分期和远处转移的关系。方法选取经消化道肠镜、影像学及病理确诊的结直肠癌患者182例作为试验组。选择同期进行肠镜检查并确诊为结直肠息肉良性病变的86例患者作为对照组。分别测定两组患者血清中癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)及sST2的水平,并分析其与肿瘤分期和远处转移的相关性。采用受试者工作特征曲线(ROC曲线)评价sST2联合血清肿瘤标志物CEA、CA19-9、CA125检测对结直肠癌的诊断效能。结果试验组患者sST2水平明显高于对照组,差异有统计学意义(P<0.05)。结直肠癌患者中的sST2表达水平不受性别、年龄、病理分型和肿瘤大小影响,有淋巴转移和远处转移的结直肠癌患者sST2表达水平高于未转移的患者,不同TNM分期和肿瘤分化程度结直肠癌患者sST2水平差异有统计学意义(P<0.05)。Pearson相关分析显示,血清sST2水平与结直肠癌的分期和转移呈明显正相关。ROC曲线分析显示,sST2联合CEA、CA19-9、CA125诊断结肠癌的ROC曲线下面积(AUC=0.917)高于sST2单独诊断(AUC=0.770)及CEA联合CA19-9、CA125(AUC=0.874)。结论sST2能在一定程度上反映结直肠癌的恶性程度及肿瘤转移能力,sST2和血清肿瘤标志物联合检测可以有效提高结直肠癌的诊断效能。Objective To investigate the expression level of soluble ST2(sST2)in colorectal cancer and to analyze the relationship with tumor staging and distant metastasis.Methods A total of 182 patients with colorectal cancer diagnosed by colonoscopy,imageological diagnosis and pathology were selected as the experimental group.In addition,86 patients with benign colorectal polyps confirmed by colonoscopy at the same time were selected as the control group.Levels of CEA,CA19-9,CA125 and sST2 were tested,and their correlation with tumor stage and distant metastasis were analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of sST2 combined with serum tumor markers CEA,CA19-9 and CA125 for colorectal cancer.Results The level of sST2 in the experimental group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).SST2 expression level in patients with colorectal cancer was not affected by gender,age,pathological type and tumor size,and the expression level of sST2 in colorectal cancer patients with lymph node metastasis and distant metastasis was higher than that in patients without metastasis.The level of sST2 in colorectal cancer patients with different TNM stages and tumor differentiation degree also had significant difference(P<0.05).Pearson correlation analysis showed that serum sST2 level was positively correlated with colorectal cancer staging and metastasis.According to The ROC curve analysis,the area under the ROC curve of sST2 combined with CEA,CA19-9 and CA125(AUC=0.917)in the diagnosis of colon cancer was higher than that of sST2 alone(AUC=0.770)and CEA combined with CA19-9 and CA125(AUC=0.874).Conclusion SST2 could represent the malignant degree of colorectal cancer and the ability of tumor metastasis to a certain extent.The combined detection of sST2 and serum tumor markers could effectively improve the diagnostic efficacy of colorectal cancer.

关 键 词：结直肠癌 肿瘤标志物 肿瘤分期 肿瘤转移 

分 类 号：R735.3[医药卫生—肿瘤]