原肌球蛋白-4联合CEA、CA19-9在结肠癌中的表达及其临床意义
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摘要
目的探究原肌球蛋白-4(tropomyosin-4,Tm-4)联合癌胚抗原(carcinoembryonic antigen,CEA)、癌抗原19-9(cancer antigen 19-9,CA19-9)在结肠癌中的表达及临床意义。方法收集我院确诊结肠癌100例为病例组,收取100例结肠良性疾病为良性病变组,同期收取在我院的健康人群100例为对照组。采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测血清Tm-4;采用化学发光法分别检测血清CEA与CA19-9水平。结果单因素方差分析结果显示,三组间血清Tm-4、CEA和CA19-9水平差异均具有统计学意义(P <0. 05)。组间比较显示,病例组的血清Tm-4、CEA和CA19-9水平均显著高于良性病变组和对照组,差异具有统计学意义(P <0·05)。血清Tm-4、CEA和CA19-9水平与结肠癌分期(Tm-4:r=0.567,P=0.002;CEA:r=0.552,P=0.006;CA19-9:r=0.535,P=0.011)、组织学类型(Tm-4:r=0.559,P=0.001;CEA:r=0.539,P=0.007;CA19-9:r=0.538, P=0.017)及分化程度(Tm-4:r=0.514,P=0.006;CEA:r=0.501,P=0.018;CA19-9:r=0.497,P=0.023)呈线性关联,且Tm-4、CEA和CA19-9在中晚期结肠癌、未分化癌及低分化结肠癌患者中的水平增高最显著。受试者工作特征曲线显示,联合Tm-4、CEA和CA19-9区分结肠癌与良性病变组和对照组的灵敏度/特异性为88.1%/93.4%。相比低Tm-4组,高Tm-4组患者的生存时间显著缩短(χ~2=13.929,P<0.001);相比低CEA组,高CEA组患者的生存时间显著缩短(X~2=10.157,P=0.001);相比低CA19-9组,高CA19-9组患者的生存时间显著缩短(χ~2=4.364,P=0.037)。结论联合血清Tm-4、CEA和CA19-9对结肠癌具有诊断及预后评估价值,且与结肠癌分期、组织学类型、分化程度显著相关。
Objective To investigate the expression and clinical significance of tropomyosin-4( Tm-4)combined with carcinoembryonic antigen(CEA)and cancer antigen 19-9(CA19-9)in colon cancer. Methods100 patients with colon cancer were selected as the case group, 100 patients with benign colorectal diseases as the benign lesion group,and 100 healthy people as the control group. Serum Tm-4 was detected by enzymelinked immunosorbent assay( ELISA), and the levels of CEA and CA19-9 were detected by chemiluminescence. Results The results of one-way ANOVA showed that the levels of serum Tm-4,CEA and CA19-9 were significantly different among the three groups(P <0.05). The serum levels of Tm-4,CEA and CA19-9 in the case group were significantly higher than those in the benign lesion group and the control group(P<0.05). The levels of serum Tm-4,CEA and CA19-9 were correlated with the stages of colon cancer(Tm-4:r = 0.567,P =0.007; CEA:r = 0.552,P =0.006; CA19-9:r = 0. 535,P =0. 011),histological type(Tm-4:r = 0.559,P=0.001; CEA:r = 0.539,P =0.007; CA19-9:r = 0.538,P=0.017)and differentiation(Tm-4:r =0.514,P=0.06; CEA:r = 0.501,P=0.018; CA19-9:r = 0.497,P =0.023),indicating a linear correlation pattern,and the levels of Tm-4,CEA and CA19-9 in patients with advanced,undifferentiated and poorly differentiated colon cancer increased most significantly. Receiver operating characteristic results showed that the sensitivity/specificity of combination of Tm-4,CEA and CA19-9 in differentiating colon cancer from benign lesion group and control group was 88. 1%/93.4%. Survival analysis showed that the survival time of high Tm-4 group was significantly shorter than that of low Tm-4 group(X~2=13. 929, P < 0. 001); the survival time of high CEA group was significantly shorter than that of low CEA group(X~2= 10. 157,P =0.001);and the survival time of high CA19-9 group was significantly shorter than that of low CA19-9 group(X~2=4. 364, P = 0. 037). Conclusion Combined serum Tm-4, CEA and CA19-9 have diagnostic and prognostic value for colon cancer, and are significantly correlated with the stage, histological type and differentiation of colon cancer.
Objective To investigate the expression and clinical significance of tropomyosin-4( Tm-4)combined with carcinoembryonic antigen(CEA)and cancer antigen 19-9(CA19-9)in colon cancer. Methods100 patients with colon cancer were selected as the case group, 100 patients with benign colorectal diseases as the benign lesion group,and 100 healthy people as the control group. Serum Tm-4 was detected by enzymelinked immunosorbent assay( ELISA), and the levels of CEA and CA19-9 were detected by chemiluminescence. Results The results of one-way ANOVA showed that the levels of serum Tm-4,CEA and CA19-9 were significantly different among the three groups(P <0.05). The serum levels of Tm-4,CEA and CA19-9 in the case group were significantly higher than those in the benign lesion group and the control group(P<0.05). The levels of serum Tm-4,CEA and CA19-9 were correlated with the stages of colon cancer(Tm-4:r = 0.567,P =0.007; CEA:r = 0.552,P =0.006; CA19-9:r = 0. 535,P =0. 011),histological type(Tm-4:r = 0.559,P=0.001; CEA:r = 0.539,P =0.007; CA19-9:r = 0.538,P=0.017)and differentiation(Tm-4:r =0.514,P=0.06; CEA:r = 0.501,P=0.018; CA19-9:r = 0.497,P =0.023),indicating a linear correlation pattern,and the levels of Tm-4,CEA and CA19-9 in patients with advanced,undifferentiated and poorly differentiated colon cancer increased most significantly. Receiver operating characteristic results showed that the sensitivity/specificity of combination of Tm-4,CEA and CA19-9 in differentiating colon cancer from benign lesion group and control group was 88. 1%/93.4%. Survival analysis showed that the survival time of high Tm-4 group was significantly shorter than that of low Tm-4 group(X~2=13. 929, P < 0. 001); the survival time of high CEA group was significantly shorter than that of low CEA group(X~2= 10. 157,P =0.001);and the survival time of high CA19-9 group was significantly shorter than that of low CA19-9 group(X~2=4. 364, P = 0. 037). Conclusion Combined serum Tm-4, CEA and CA19-9 have diagnostic and prognostic value for colon cancer, and are significantly correlated with the stage, histological type and differentiation of colon cancer.
引文
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[10] KABBAGE M,TRIMECHE M,BEN NASR H,et al. Tropomyosin-4correlates with higher SBR grades and tubular differentiation in infiltrating ductal breast carcinomas:an immunohistochemical and proteomics-based study[J]. Tumour Biol, 2013, 34(6):3593-3602.
[11] JIANG R, ZHANG C, LIU G, et al. MicroRNA-107 promotes proliferation, migration, and invasion of osteosarcoma cells by targeting tropomyosin[J]. Oncol Res,2017,25(8):1409-1419.
[2] ZHANG H,WANG Z,MA R,et al. MicroRNAs as biomarkers for the progression and prognosis of colon carcinoma[J]. Int J Mol Med,2018,42(4):2080-2088.
[3] ZHAI H,HUANG J, YANG C, et al. Serum CEA and CA19-9levels are associated with the presence and severity of colorectal neoplasia[J]. Clin Lab,2018,64(3):351-356.
[4]孙小莉,曹晓侠.血管内皮生长因子(VEGF)和血清癌胚抗原(CEA)在直肠癌中的表达及其临床意义[J].实用癌症杂志,2016,31(11):1778-1781.
[5] ATTALLAH A M,EL-FAR M,IBRAHIM A R,et al. Clinical value of a diagnostic score for colon cancer based on serum CEA,CA19-9,cytokeratin-1 and mucin-1[J]. Br J Biomed Sci,2018,75(3):122-127.
[6]刘懿,赵四海.结直肠癌患者血清TK1、sICAM-1、miR-210、CEA的检测及分析[J].国际检验医学杂志,2018,39(9):1048-1051,1055.
[7] BENSON A B 3rd, BEKAII-SAAB T, CHAN E, et al. Localized colon cancer, version 3. 2013:featured updates to the NCCN Guidelines[J]. J Natl Compr Canc Netw,2013,11(5):519-528.
[8] ATTALLAH A M,EL-FAR M,IBRAHIM A R,et al. Clinical value of a diagnostic score for colon cancer based on serum CEA,CA19-9,cytokeratin-I and mucin-I[J]. Br J Biomed Sci,2018,75(3):122-127.
[9] CHEN Z,YIN X, LI K,et al. Serum levels of TRIM72 are lower among patients with colon cancer:identification of a potential diagnostic marker[J]. Tohoku J Exp Med,2018,245(1):61-68.
[10] KABBAGE M,TRIMECHE M,BEN NASR H,et al. Tropomyosin-4correlates with higher SBR grades and tubular differentiation in infiltrating ductal breast carcinomas:an immunohistochemical and proteomics-based study[J]. Tumour Biol, 2013, 34(6):3593-3602.
[11] JIANG R, ZHANG C, LIU G, et al. MicroRNA-107 promotes proliferation, migration, and invasion of osteosarcoma cells by targeting tropomyosin[J]. Oncol Res,2017,25(8):1409-1419.