肿瘤标志物蛋白芯片中结直肠癌相关指标的筛选及优化

Screening and optimizing the colorectal cancer related tumor markers from multi-tumor markers proteinchip

目的 分析C12多肿瘤标志物蛋白芯片指标与结直肠癌的相关性,筛选结直肠癌相关指标,为建立结直肠癌小型诊断芯片提供依据.方法 使用C12多肿瘤标志物蛋白芯片系统,检测173例结直肠癌患者术前血清中12种常见肿瘤标志物(CA19-9、NSE、CEA、CA242、CA125、CAl5-3、AFP、Ferritin、f-PSA、PSA、β-HCG及HGH)的水平,筛选结直肠癌相关指标,采用κ检验比较其与C12检测结果的一致性,并用成本-效果分析法,寻找最佳检测方案.结果 173例结直肠癌患者血清肿瘤标志物(TM)升高主要集中于4项指标:CEA(36.4%)、CA242(19.7%)、CA19-9(18.5%)、CA125(9.8%);采用κ检验比较4项指标不同组合与C12的检测结果,得出一致性极强的小型方案有7种,使用成本-效果分析法得出最佳方案为CEA单项指标检测.结论 C12多肿瘤标志物蛋白芯片系统对结直肠癌的辅助诊断价值有限,各项指标联合未能明显提高结直肠癌检出率,且芯片设计复杂、成本较高.因此,有必要补充新的指标,设计小型芯片,增强其临床应用价值.

Objective To analyze the association between C12 tumor markers and colorectal cancer,in order to screen for colorectal cancer related tumor markers so as to provide theoretical base for the establishment of colorectal cancer diagnostic biochips. Methods The sera of 173 colorectal cancer patients were detected for 12 common tumor markers 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, neuron-specific enolase (NSE),human chorionic gonagotropin-beta (β-HCG), human growth hormone (HGH), and ferritin using the C12tumor markers proteinchip, and colorectal cancer related parameters were analyzed by Kappa test and cost-effectiveness analysis to find the most optimal tumor marker program. Results CEA (36.4 %), CA242(19.7 %), CA19-9 (18.5 %), CA125(9.8 %) were major tumor markers increased among the 173 colorectal cancer patients. Kappa test revealed 7 tumor marker programs having strong consistency with the detection results of C12 tumor markers proteinchip, and CEA singly detected was proved to be the best program by cost-effectiveness analysis. Conclusion C12 tumor markers proteinchip system have limited value in the diagnosis of colorectal cancer, but the design of chip is too complicated and costly for widespread screening among the high risk populations. Searching for new colorectal cancer biomarkers and designing small diagnostic chip could significantly enhance the clinical value of tumor markers in terms of diagnostic rate and practical utility.