RANTES与肿瘤标志物联合检测在结直肠癌诊疗中的应用  

Application of combined detection of RANTES and tumor markers in the diagnosis of colorectal cancer

作　　者：韦丽丽 谭会柳 张瀞丹 李伟倩 贾会真 杨湘玲[1,2,3] 刘焕亮 WEI Lili;TAN Huiliu;ZHANG Jingdan;LI Weiqian;JIA Huizhen;YANG Xiangling;LIU Huanliang(Department of Clinical Laboratory,the Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510655,China;Guangdong Institute of Gastroenterology,Guangzhou,Guangdong 510655,China;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,Guangzhou,Guangdong 510655,China)

机构地区：[1]中山大学附属第六医院临床检验科,广东广州510655 [2]广东省胃肠病学研究所,广东广州510655 [3]广东省结直肠盆底疾病研究重点实验室,广东广州510655

出　　处：《国际检验医学杂志》2023年第S01期4-10,共7页International Journal of Laboratory Medicine

基　　金：国家自然科学基金(81772573)。

摘　　要：目的本研究旨在探索细胞因子在结直肠癌患者与健康者之间的差异表达,及筛选出的高表达细胞因子与肿瘤标志物联合检测在结直肠癌诊疗中的作用。方法利用细胞因子微阵列分析结直肠癌患者和健康人血浆细胞因子表达谱;采用酶联免疫法(ELISA)检测筛选出的结直肠癌患者血浆中高表达细胞因子。用受试者工作特征(ROC)曲线评价癌胚抗原(CEA)、糖类抗原125(CA125)、CA199和经过筛选获得的细胞因子:受激活调节正常T细胞表达和分泌因子(RANTES)在鉴别结直肠癌患者和健康者的诊断性能。所有数据使用SPSS23.0和Graph Pad Prism 8.0进行统计分析,验证CEA、CA125、CA199和RANTES在结直肠癌患者和健康者之间差异表达采用Mann-Whitney U检验。通过计算Youden指数来确定RANTES水平的最佳临界值,以鉴别结直肠癌患者。用二元Logistic回归模型结合血清/血浆生物标志物的诊断效果进行拟合。所有统计检验均为双侧检验,差异有统计学意义(P<0.05)。结果与健康者相比,结直肠癌患者血浆RANTES显著高表达,差异有统计学意义(P<0.001)。RANTES的ROC曲线下面积为0.846(95%CI:0.791~0.901);RANTES和CEA联合检测AUC为0.891(95%CI:0.854~0.929),灵敏度和特异度分别达到0.854和0.803。结论RANTES对结直肠癌有诊断价值,RANTES联合CEA检测较单独检测CEA有更高的结直肠癌诊断效能。Objective To explore the differential expression of cytokines between colorectal cancer(CRC)patients and healthy individuals,and the role of screening high expression cytokines and tumor markers for combined detection in the diagnosis and treatment of colorectal cancer.Methods The plasma cytokine expression profiles of CRC patients and healthy controls were analyzed by inflammatory cytokine microarray.The high-expression cytokine was detected by enzyme-linked immunosorbent assay(ELISA).ROC curve was used to evaluate the diagnostic performance of Carcinoembryonic Antigen(CEA),Carbohydrate Antigen 125(CA125),Carbohydrate Antigen 199(CA199),and the cytokine obtained after screening:activation-regulated normal T cell expression and secretion factor(RANTES)in the diagnosis of healthy controls and CRC patients.All data were analyzed by SPSS 23.0 and Graph Pad Prism 8.0.The different expression of CEA,CA125,CA199 and RANTES between CRC patients and healthy controls was verified by Mann-Whitney U test.The cutoff value of RANTES was determined by calculating the Youden Index to identify patients with colorectal cancer.The binomial Logistic Regression model combined the diagnostic effect of serum/plasma biomarkers.All statistical tests were bilateral,and the difference was statistically significant(P<0.05).Results Compared with healthy controls,the expression of RANTES in CRC patients′plasma was significantly higher,and the difference was statistically significant(P<0.001).The area under curve(AUC)value of CEA was 0.846(95%CI:0.791-0.901),and the AUC value of RANTES and CEA was 0.891(95%CI:0.854-0.929),the specificity and sensitivity were 0.803 and 0.854,respectively.Conclusion RANTES have diagnostic value for colorectal cancer,and RANTES combined with CEA have higher diagnostic efficacy than CEA alone.

关 键 词：受激活调节正常T细胞表达和分泌因子 结直肠癌 细胞因子 肿瘤标志物 

分 类 号：R734.2[医药卫生—肿瘤] R730.43[医药卫生—临床医学]