半胱氨酸蛋白酶抑制剂S在胃肠癌中的诊断价值研究  

Value of cysteine proteinase inhibitor S in the diagnosis of gastrointestinal cancer

作　　者：吴明兰 林美花 翟优 吕朵 张乔 吴国兰[1,3] 冯立民 申屠建中[1,3] WU Ming-lan;LIN Mei-hua;ZHAI You;LV Duo;ZHANG Qiao;WU Guo-lan;FENG Li-min;SHENTU Jian-zhong(Department of Clinical Pharmacy,The First Affiliated Hospital,Zhejiang University,School of Medicine,Hangzhou 310003,Zhejiang Province,China;Department of Clinical Laboratory,The First Affiliated Hospital,Zhejiang University,School of Medicine,Hangzhou 310003,Zhejiang Province,China;Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research,Hangzhou 310003,Zhejiang Province,China)

机构地区：[1]浙江大学医学院附属第一医院临床药学部,浙江杭州310003 [2]浙江大学医学院附属第一医院检验科,浙江杭州310003 [3]浙江省药物临床研究与评价技术重点实验室,浙江杭州310003

出　　处：《中国临床药理学杂志》2021年第5期503-506,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(81903849);浙江省医学会临床科研基金资助项目(2018ZYC-A11);浙江省中医药科技计划青年人才基金资助项目(2018ZQ033)。

摘　　要：目的探索术前半胱氨酸蛋白酶抑制剂S(CST4)在胃肠癌中的诊断价值。方法收集胃癌患者(109例)和结直肠癌患者(147例)的术前血清标本。另收集胃和结直肠良性疾病患者(各23例)、健康人(62例)血清标本和干扰样本(45例,包括高脂、溶血、风湿因子阳性、高同型半胱氨酸、甲状腺结节和乳腺结节)作为胃良性疾病组。用酶联免疫吸附法测定各组血清CST4水平。Kruskal-Wallis检验比较组间差异,用受试者工作特征(ROC)曲线分析CST4在胃肠癌诊断中的价值。结果胃癌和结直肠癌患者血清CST4浓度中位数分别为77.75和86.19 pg·mL^(-1),均明显高于胃良性疾病组的40.00 pg·mL^(-1);同时,胃癌患者CST4中位数水平显著高于胃良性疾病组(40.00 pg·mL^(-1)),差异均有统计学意义(均P<0.05)。Ⅳ期的胃癌和结直肠癌患者的CST4浓度中位数分别为193.45和245.49 pg·mL^(-1),显著高于Ⅰ至Ⅲ期患者,差异均有统计学意义(均P<0.05)。胃癌患者CST4的ROC曲线下面积(AUC)为0.71,高于其他肿瘤标志物;而结直肠癌患者CST4的AUC为0.67,仅次于癌胚抗原(CEA)的0.78。结论CST4对胃肠癌尤其是胃癌的诊断具有较高的参考价值,可推荐作为胃肠癌筛查的肿瘤标志物。Objective To investigate the diagnostic value of cysteine proteinase inhibitor S(CST4)in gastrointestinal cancer.Methods Preoperative serum samples were collected from patients diagnosed with gastric cancer(n=109)and colorectal cancer(n=147).Also,serum samples from patients with benign gastric disease(n=23),benign colorectal disease(n=23),62 healthy people and 45 interference samples(samples from patients with hyperlipidemia,rheumatic factor positivity,hyperhomocysteinemia,thyroid nodules,breast nodules and hemolytic)were collected as control.Enzyme-linked immunosorbent assay was used to test serum CST4 concentration.The CST4 expression between different groups was compared via Kruskal-Wallis test.And the diagnostic value of CST4 and other tumor biomarkers was assessed using receiver operating characteristic(ROC)curve.Results Comparison between median CST4 concentrations of 77.75 pg·mL^(-1)and 86.19 pg·mL^(-1)for gastric cancer and colorectal cancer significantly higher than that of 40.00 pg·mL^(-1)for healthy control(all P<0.05).And median concentration of CST4 of gastric cancer higher than that of 40.00 pg·mL^(-1)for benign gastric disease(P<0.05).Median CST4 levels of the gastric cancer and colorectal cancer in stageⅣ(193.45 pg·mL^(-1)and 245.49 pg·mL^(-1),respectively)higher than that in stageⅠ,stageⅡand stageⅢwith significant(all P<0.05).Highest CST4 area under curve(AUC)of 0.71 for gastric cancer,while AUC of CST4 in patients with colorectal cancer(0.67)was only second to that of 0.78 for carcinoembryonic antigen(CEA).Conclusion CST4 shows a high value for the diagnosis of gastrointestinal cancer especially in gastric cancer,which can be recommended as biomarker for cancer screening.

关 键 词：半胱氨酸蛋白酶抑制S 胃癌 结直肠癌 肿瘤标志物 诊断 

分 类 号：R97[医药卫生—药品]