SAA、CRP在胃肠道肿瘤病理分期及转移中的临床价值  

Clinical roles of SAA and CRP in pathological staging and metastasis of gastrointestinal cancer

作　　者：熊仲波 王蕾[1] 殷蓓琦 戴悦[1] 卫晓青 卢培[1] XIONG Zhongbo;WANG Lei;YIN Beiqi;DAI Yue;WEI Xiaoqing;LU Pei(Department of Clinical Laboratory,Shanghai Eighth People's Hospital,Shanghai 200235,China)

机构地区：[1]上海市第八人民医院检验科,上海200235

出　　处：《检验医学》2022年第1期51-55,共5页Laboratory Medicine

基　　金：上海市科学技术委员会科研计划项目(17DZ1930301-06)。

摘　　要：目的探讨血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)在胃肠道肿瘤分期中的临床价值。方法选取胃肠道肿瘤患者400例(胃癌157例、结直肠癌243例)(胃肠道肿瘤组)、炎性息肉患者97例(息肉组)及体检健康者104名(正常对照组)。检测所有患者术前及正常对照者SAA、CRP、癌胚抗原(CEA)、糖类抗原(CA)242、CA19-9及CA50水平,收集胃肠道肿瘤患者术后的病理分期资料。采用受试者工作特征(ROC)曲线分析各项指标判断肿瘤分期的价值。结果胃肠道肿瘤组SAA、CRP、CA242、CA19-9、CEA、CA50水平均高于正常对照组及息肉组(P<0.01)。息肉组与正常对照组各项指标差异均无统计学意义(P>0.05)。胃肠道肿瘤患者不同临床分期之间、不同T分期及不同N分期之间SAA水平差异均有统计学意义(P<0.05),不同M分期之间SAA水平差异均无统计学意义(P>0.05)。胃肠道肿瘤患者不同病理分期之间CRP水平差异均无统计学意义(P>0.05)。ROC曲线分析结果显示,SAA、CRP、CA242、CA19-9、CEA、CA50单项检测判断胃肠道肿瘤淋巴结转移的曲线下面积(AUC)分别为0.732、0.505、0.626、0.631、0.604和0.625。不同联合检测组合中,SAA+CRP+CA242组合的效能最高,联合检测模型为Logit(P)=-0.988+0.013×SAA+0.003×CRP+0.010×CA242,判断胃肠道肿瘤淋巴结转移的AUC为0.769。结论SAA、CRP在胃肠道肿瘤的病理分期及判断淋巴结转移中均有一定的临床价值。Objective To investigate the clinical roles of serum amyloid A(SAA)and C-reactive protein(CRP)in gastrointestinal cancer staging.Methods Totally,400 patients with gastrointestinal cancer(157 gastric cancer cases and 243 colorectal cancer cases),97 polyp patients and 104 healthy subjects were recruited.The levels of SAA,CRP,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)242,CA19-9 and CA50 were determined,and the patients’pathological stage data were collected postoperatively.The role of tumor stage was judged by each index using receiver operating characteristic(ROC)curve.Results The levels of SAA,CRP,CA242,CA19-9,CEA and CA50 were higher in gastrointestinal cancer group than those in healthy control and polyp groups(P<0.01).There was no statistical significance for all the indicators in polyp group and healthy control group(P>0.05).SAA levels had statistical significance among different clinical stages,different T stages and different N stages in gastrointestinal cancer patients(P<0.05),and there was no statistical significance between different M stages(P>0.05).CRP levels had no statistical significance among different pathological stages in patients with gastrointestinal cancer(P>0.05).The areas under curves(AUC)of SAA,CRP,CA242,CA19-9,CEA and CA50 single determinations for the evaluation of lymph node metastasis in gastrointestinal cancer were 0.732,0.505,0.626,0.631,0.604 and 0.625,respectively.The highest efficacy of the SAA+CRP+CA242 combined determination was observed.The combined determination model was Logit(P)=-0.988+0.013×SAA+0.003×CRP+0.010×CA242,and the AUC for judging lymph node metastasis of gastrointestinal cancer was 0.769.Conclusions SAA and CRP can be considered clinically useful in pathological staging and lymph node metastasis judging of gastrointestinal cancer.

关 键 词：血清淀粉样蛋白A C反应蛋白 肿瘤标志物 病理分期 胃癌 结直肠癌 

分 类 号：R446.1[医药卫生—诊断学]