肺腺癌患者外周血斯钙素1的检测和临床意义

Detection and significance of STC1 in peripheral blood of patients with pulmonary adenocarcinoma

目的为肺腺癌的诊断寻找一种新的肿瘤标志物。方法采用逆转录-聚合酶链反应（RT-PCR）方法检测45例肺腺癌患者和52名健康成人外周血中的斯钙素1（stanniocalcin 1,STC1）基因表达,并采用化学发光微粒子免疫分析（CMIA）技术检测癌胚抗原（CEA）、糖类抗原125（CA125）、糖类抗原211（CA211）、神经元特异烯醇化酶（NSE）等血清肿瘤标志物,将肺腺癌STC1基因表达结果与临床病理资料及上述肿瘤标志物检出率进行比较。结果 45例肺腺癌患者外周血中STC1基因的阳性率为48.89%（22/45）,并与临床分期、淋巴结转移有显著相关性（P〈0.05）;而健康成人的外周血中则无1例出现阳性。STC1分别与CA211、CA125、NSE阳性比较,2种方法检出率差异有统计学意义（P〈0.05）;STC1与联合CEA、CA125、CA211、NSE 4种标志物中1项指标阳性即为阳性比较,认为2种方法检出率基本一致（P〉0.05）。用受试者工作特征（ROC）曲线进行灵敏度和特异度的综合评价,ROC曲线下面积为0.744（95%可信区间：0.646~0.828,P〈0.01）。结论本研究提示检测外周血STC1基因对肺腺癌具有较高的诊断价值,STC1可能会成为检测肺腺癌的新的肿瘤标志物。

Objective To search a novel tumor bio-marker for pulmonary adenocarcinoma.Methods The expression of stanniocalcin 1（STC1） gene in peripheral blood of 45 patients with pulmonary adenocarcinoma and 52 healthy subjects was determined by reverse transcription-polymerase chain reaction（RT-PCR）,and 4 serum tumor markers [carcinoembryonic antigen（CEA）,carbohydrate antigen 125（CA125）,carbohydrate antigen 211（CA211） and neuron specific enolase（NSE）] were also determined by chemiluminescence microparticle immunoassay（CMIA）.The expression result and the detection rate of tumor markers were compared.Results Among 45 patients with pulmonary adenocarcinoma,22 patients（48.89%） showed the expression of STC1 gene positive,while there was no expression of STC1 in the healthy subjects.The expression of STC1 gene was correlated with the clinical stage and lymph node metastasis（P0.05）.The comparison of STC1 with CA211,CA125 and NSE showed that the positive detection rate had statistical significance（P0.05）.The comparison between STC1 and the combination of CEA,CA125,CA211 and NSE showed that the two methods were basically the same prevalence（P0.05）.The comprehensive evaluation of sensitivity and specificity by receiver operating characteristic（ROC） curve showed that the area under the ROC curve was 0.744（95% confidence interval： 0.646-0.828,P0.01）.Conclusions STC1,as a novel tumor marker for pulmonary adenocarcinoma,has a high diagnosis value.