多肿瘤标志物蛋白质芯片检测系统对结直肠癌诊断的临床意义

Clinical significance of C-12 multiple tumor marker protein chip detective system in diagnosing colorectal carcinoma

目的探讨多肿瘤标志物蛋白质芯片检测系统(C-12)在结直肠癌诊断中的临床意义,并建立联合诊断结直肠癌的函数,以提高肿瘤标志物诊断结直肠癌的准确率。方法采用蛋白质芯片法检测239例结直肠癌、79例结直肠良性病变和1 203例正常体检者12项肿瘤标志物的水平,并建立联合诊断函数。结果(1)结直肠癌组蛋白芯片的阳性率为71.97%,显著高于结直肠良性病变和正常体检组。C-12芯片检测结直肠癌的灵敏度是71.97%,特异度是55.7%,阳性预测值是83.09%,阴性预测值是39.64%;联合检测的阳性率显著高于单项肿瘤标志物的检测(P<0.05)。(2)CA199、CEA、CA242、AFP、-βHCG,HGH以及CA125阳性率明显高于良性病变组和正常体检组(P<0.05),同时CA199、CEA、CA242和CA125联合检测的灵敏度和准确率明显高于单项检测指标。(3)CA199、CEA、CA242以及CA125表达强度和肿瘤预后相关。(4)建立结直肠癌判别诊断函数,对肿瘤的诊断准确率为86.4%,显著高于联合检测。结论联合检测多肿瘤标志物对结直肠癌的诊断和预后判断具有重要意义。本研究建立的联合诊断函数能提高结直肠癌诊断准确率。

Objective To evaluate the clinical values of C-12 multiple tumor marker protein chip detective system for colorectal carcinoma and to enhance the accuracy rate by establishing the diagnostic function. Methods Twelve tumor markers were detected by protein chip technology in 239 cases of colorectal carcinoma,79 cases of benign diseases and 1203 cases of normal control. To establish the diagnostic function with those data, Results （1）The positive ratio was 71.97% in colorectal carcinoma,which was significantly higher than the other two groups. The sensitivity, specificity, accuracy, positive predict value and negative value of C-12 system were 71. 97%,55.7%, 83.09% ,39.64%. The positive ratio of combined detection was higher than everyone of C-12 system only（P〈 0. 05 ）. （ 2 ） The expression of tumor markers CA199, CEA, CA242, AFP, β-HCG, HGH and CA125 in carcinoma group was markedly stronger than that of other two groups, meanwhile the sensitivity and validity of combined detection of CA199 ,CEA,CA242 were proved. （3） The level of CA199,CEA,CA242 and CA125 was related to prognosis in colorectal carcinoma. （4） Diagnostic function was established. The accuracy rate of diagnostic function in colorectal carcinoma was 86.4% ,which significantly higher than that with combined detection. Conclusion It is helpful to diagnose colorectal carcinoma and predict prognosis with combined detection of tumor markers. The accuracy rate rises when using combining diagnostic function.