肿瘤标志物在结直肠癌诊断和监测中的价值和改进策略:130例患者的临床资料分析(英文)

Value of Tumor Markers in Diagnosing and Monitoring Colorectal Cancer and Strategies for Further Improvement: Analysis of 130 Cases

背景与目的:肿瘤标志物检测是肿瘤血清学诊断的主要方法之一,但肿瘤标志物的阳性诊断率较低。本研究旨在分析肿瘤蛋白芯片C12在结直肠癌(colorectal cancer,CRC)诊断中的价值。方法:分析总结130例CRC初治患者12种肿瘤标志物的检测结果,找出与CRC相关性最强的肿瘤标志物,计算各标志物组检测对提高诊断率的作用。结果:C12对本组CRC患者的总体诊断率是42.3%,对Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的诊断率分别是13.6%、39.5%、38.2%和68.8%;对Ⅳ期患者的诊断率显著高于Ⅰ期患者(P<0.001);癌胚抗原(carcioembryonic antigen,CEA)的阳性率最高,达35.4%,与之相比,阳性率最高的5种标志物的任何组合方式(2、3、4、5种标志物的组合)均不能提高诊断率,但四项指标联合检测CEA+前列腺特异性抗原(free prostate specific antigen,f-PSA)+肿瘤抗原(cancer antigen,CA)125+CA242或CEA+CA19-9+CA125+f-PSA足以替代12项指标联合检测。结论:C12对诊断中晚期CRC有一定价值,但对早期CRC的灵敏度不高。

BACKGROUND ＆ OBJECTIVE： Measurement of blood tumor markers is the most widely used and convenient method for the diagnosis of colorectal cancer（CRC）. This study was to evaluate the diagnostic value of a biochip diagnostic system C12 in the diagnosis of CRC. METHODS： Twelve tumor markers were detected in the sera of 130 pathologically confirmed CRC patients, including carcinoembryonic antigen （CEA）, alpha-fetoprotein （AFP）, carbohydrate antigen 19-9 （CA19-9）, carbohydrate antigen 242 （CA242）, cancer antigen 15-3 （CA15-3）, cancer antigen 125 （CA125）, prostate specific antigen （PSA）, free-PSA （f-PSA）, neuron-specific enolase （NSE）, human chorionic gonagotropin-beta （15-HCG）, human growth hormone （HGH）, and ferritin, using the C12 diagnostic biochip system. The most relevant tumor markers and the most useful combinations of tumor markers were determined. RESULTS. The overall diagnostic rate for the 130 patients was 42.3%; and the diagnostic rates were 13.6%, 39.5%, 38.2% and 68.8%, for stages Ⅰ , Ⅱ , Ⅲ and Ⅳ patients, respectively. There was significant difference in the diagnostic rates between stage Ⅰ and stage Ⅳ patients. Among all the 12 markers, CEA had the highest diagnostic rate of 35.4%. Any combinations of the 5 most relevant tumor markers did not significantly improve the diagnostic rate. However, the combination of 4 markers （CEA＋f-PSA ＋ CA125＋CA242 or CEA＋CA19-9＋CA125＋f-PSA） was as good as 12 markers in terms of diagnosis. CONCLUSIONS. The C12 biochip diagnostic system has some value in the diagnosis of advanced CRC, but its sensitivity for the diagnosis of early CRC is not satisfactory.