趋化因子配体CCL18在胃癌诊断中的价值

The diagnostic value of chemokine CC-motif ligand 18(CCL18) for gastric cancer

目的探讨趋化因子配体CCL18在胃癌诊断中的应用价值。方法采用免疫组化法分别检测78例胃癌、30例慢性胃炎和30例正常对照组织标本中CCL18的表达水平,同时与传统肿瘤标志物CEA、CA19-9进行比较。结果CCL18在76.92%(60/78)的胃癌组织中呈阳性表达,与慢性胃炎组、正常对照组对比有极显著差异(P<0.01)。在回顾性研究中,CCL18对胃癌诊断的敏感性、特异性、约登指数(Youden’s index)、阳性预测值(PPV)和阴性预测值(NPV)分别为76.92%、78.34%、0.5524、82.19%和72.31%;CCL18对胃癌诊断的敏感性显著高于CEA及CA19-9(P<0.01);其特异性低于CEA(P<0.05)而与CA19-9差异无统计学意义(P=0.142);三种指标间的约登指数、PPV和NPV均无显著性差异(P>0.05)。在34例早期胃癌中,CCL18的敏感性更优于CEA和CA19-9(P<0.01),高达88.24%,约登指数(0.6658)也明显高于后两者。结论趋化因子配体CCL18对胃癌,尤其是对早期胃癌的诊断具有高度敏感性,可作为一种新的肿瘤标志物为胃癌的诊断提供新的选择,有望提高早期胃癌的检出率。

Objective To detemine the diagnostic value of chemokine CC-motif ligand 18 （CCL18） for gastric cancer. Methods Immunohistochemistry assay was used to detect the expressions of CCL18 in 78 cases of gastric cancer, 30 cases of chronic gastritis and 30 normal gastric tissues. Diagnostic value was also compared with traditional tumor marker as CEA and CA19-9. Results The positive expression of CCLt 8 was in 76.92% （60/78） cases of gastric cancer, which was significantly higher than in chronic gastritis and control groups （P 〈0.01）. In this retrospective study, the sensitivity, specificity, Youden＇ s index, positive predictive value （PPV） and negative predictive value （NPV） of CCL18 for diagnosis of gastric cancer were 76.92% , 78.34% , 0. 5524, 82.19% and 72.31% , respectively. The sensitivity of CCL18 expression for diagnosis of gastric cancer was significantly higher than that of CEA and CA19-9 （P 〈0.01）. However, its specificity was lower than CEA （P 〈0.05） but not lower than CA19-9 （P =0. 142）. There were no significant difference in Youden＇s index, PPV and NPV among the three markers （P 〉0.05）. The sensitivity can be up to 88.24% in 34 cases of early gastric cancer, which showed a significantly higher sensitivity than CEA and CA19-9. Similarly, Youden＇ s index （0. 6658） was also higher than CEA and CA19-9. Conclusion CCL18 shows a high sensitivity in the diagnosis of gastric cancer, especially in early gastric cancer. It is suggested in this study that CCL18, as a novel candidate of gastric cancer marker, may improve the detective rate of the early gastric cancer.