基于血清Netrin-1和CEA水平诊断结直肠癌肝转移预测模型的建立  

Development of a prediction model based on serum Netrin-1 and CEA levels for colorectal cancer liver metastases

作　　者：王玉 陈宇翔 于倩倩 虞卫新 孙冬林[2] Wang Yu;Chen Yuxiang;Yu Qianqian;Yu Weixin;Sun Donglin(Department of HepatobiliarySurgery,Jintan Affiliated Hospital ofJiangsu University,Changzhou213200,China;Department of HepatobiliarySurgery,Third Affiliated Hospital of Soochow University,Suzhou213003,China;Department of Oncology,Jintan Affiliated Hospital ofJiangsu University,Changzhou213200,China)

机构地区：[1]江苏大学附属金坛医院肝胆外科,常州213200 [2]苏州大学附属第三医院肝胆外科,常州213003 [3]江苏大学附属金坛医院肿瘤科,常州213200

出　　处：《中华转移性肿瘤杂志》2022年第1期37-41,共5页Chinese Journal of Metastatic Cancer

基　　金：2021年常州市第十三批科技计划(应用基础研究)项目(CJ20210006);江苏大学2018年度临床医学科技发展基金项目(JLY20180134);2020年常州市第十一批科技计划(社会发展科技支撑)项目(CE20205038)。

摘　　要：目的探讨血清神经突起导向因子1(Netrin-1)与结直肠癌肝转移发生风险的关系,且与癌胚抗原(CEA)联合检测对结直肠癌肝转移的诊断价值。方法纳入2015—2020年于本院收治的230例结直肠癌患者。根据Dukes分期法将纳入患者分为有、无肝转移组。血清学Netrin-1采用ELISA试剂盒测定。对单项指标、预测模型进行受试者工作特征(ROC)曲线分析,评估ROC下面积(AUC)、敏感性及特异性。结果肝转移组血清Netrin-1水平均明显高于无肝转移组(P<0.001)。经校正后血清Netrin-1水平与结直肠癌肝转移发生风险呈正相关(OR=1.003,95%CI为1.001~1.005,P=0.001)。建立CEA和Netrin-1联合判断结直肠癌肝转移的预测模型(AUC=0.748,95%CI为0.669~0.826,敏感性为0.582,特异性为0.846,准确度0.783),优于CEA及Netrin-1单独检测(均P<0.05)。结论血清Netrin-1水平升高是结直肠癌肝转移发生的独立危险因素。Netrin-1联合CEA检测对结直肠癌肝转移发生的预判模型具有良好表现,这为临床结直肠癌患者管理及肝转移早期诊断提供新思路。Objective To assess the relationship between serum Netrin-1 and colorectal cancer(CRC)liver metastases,and the diagnostic value in CRC liver metastases in combination with carcinoembryonic antigen(CEA).Methods A total of 230 patients with CRC(175 patients without liver metastases and 55 with liver metastases,based on Dukes'staging system)were selected from October 2015 to October 2020.Serum Netrin-1 levels were measured using commercial ELISA kits.The statistical analyses included binary logistic regression and receiver operating characteristics(ROC)to evaluate prediction accuracy.Results Serum Netrin-1 in CRC liver metastases patients was showed higher levels than those in CRC patients without liver metastases(P<0.001).After adjustment,serum levels of Netrin-1 were found association with the risk of CRC liver metastases(odd ratio 1.003,95%CI:1.001-1.005,P=0.001).To identify CRC liver metastases,the combination of serum CEA and Netrin-1 was showed better performance(area under ROC curve 0.748,95%CI:0.669-0.826,sensitivity 0.582,specificity 0.846,accuracy 0.783)than single markers(P values both less than 0.05).Conclusions Serum Netrin-1 is an independent risk factor of CRC liver metastases.Its combination with CEA shows fine identification performance,which offers insights to the screening and early diagnosis of CRC liver metastases.

关 键 词：结直肠癌肝转移 神经突起导向因子1 癌胚抗原 肿瘤标记物 

分 类 号：R735.34[医药卫生—肿瘤]