大肠癌患者血清HE4、DKK-1水平变化及其意义

Change in levels of serum HE4 and DKK-1 in patients with colorectal cancer and its clinical significance

目的观察大肠癌患者血清人附睾蛋白4(HE4)、分泌型糖蛋白(DKK-1)水平变化,并探讨其意义。方法选取河北医科大学第一医院收治的大肠癌患者135例(观察组),另选100例同期体检健康人群作对照(对照组),运用ELISA法检测两组血清HE4、DKK-1,并分期两者间及与大肠癌临床病理特征的相关性,绘制ROC曲线评估两者诊断大肠癌的灵敏度和特异度。结果观察组及对照组血清HE4水平分别为(30.6±11.3)、(19.5±3.2)μg/L,血清DKK-1水平分别为(49.3±12.7)、(17.2±2.2)pg/m L,两组比较,P均<0.05;血清HE4、DKK-1水平与大肠癌病变部位、组织类型、浸润深度、淋巴结转、肝转移均相关(P均<0.05);直线相关性分析显示,大肠癌患者血清HE4、DKK-1水平呈正相关(r=0.452,P<0.05);血清HE4、DKK-1诊断大肠癌的灵敏度分别为0.646、0.695,特异度分别为0.650、0.753,两指标联合诊断大肠癌的灵敏度和特异度分别为0.861、0.874,联合检测分别与单独检测比较,P均<0.05。结论大肠癌患者血清HE4、DKK-1水平升高,其水平变化与大肠癌病变部位、组织类型、浸润深度、淋巴结转、肝转移相关,二指标均可作为大肠癌诊断的血清肿瘤标志物,联合检测诊断准确性更高。

Objective To observe the changes in levels of serum human epididymis protein 4（ HE4） and Dickkopf-1（ DKK-1） in patients with colorectal cancer,and to explore its significance. Methods Totally 135 patients with colorectal cancer admitted to the First Hospital of Hebei Medical University（ observation group） were selected,and 100 healthy subjects with the same physical examination were selected as controls（ control group）. The serum levels of HE4 and DKK-1 were detected by ELISA,and the correlation between the two groups and the clinicopathological features of colorectal cancer were analyzed. The ROC curve was used to evaluate the sensitivity and specificity of the diagnosis of colorectal cancer. Results The serum HE4 levels in the observation group and the control group were（ 30. 6 ± 11. 3） and（ 19. 5 ± 3. 2） μg/L,respectively,and the serum DKK-1 levels were（ 49. 3 ± 12. 7） and（ 17. 2 ± 2. 2） pg/m L,respectively,and significant difference was found between these two groups（ both P〈0. 05）. Serum levels of HE4 and DKK-1 were related to the lesion location,tissue type,depth of invasion,lymph node metastasis,and liver metastasis（ all P〈0. 05）. Linear correlation analysis showed that there was a positive correlation between serum HE4 and DKK-1 levels in patients with colorectal cancer（ r = 0. 452,P〈0. 05）. The sensitivity of serum HE4 and DKK-1 in the diagnosis of colorectal cancer were 0. 646 and0. 695,respectively; the specificity was 0. 650 and 0. 753,respectively. The sensitivity and specificity of the two indexes combined in diagnosis of colorectal cancer were 0. 861 and 0. 874,respectively; when we compared the combination test with each single test,the difference was statistically significant,both P〈0. 05. Conclusions The levels of serum HE4 and DKK-1 in patients with colorectal cancer are elevated,and their levels are related to the lesion site,tissue type,depth of invasion,lymph node metastasis,and liver metastasis. Both indicators can be used as serum tumor markers for colorectal cancer diagnosis,and the diagnostic accuracy of the combination detection is higher.