血清巨噬细胞抑制因子-1水平在胃癌诊断中的应用价值

The application Value of Macrophage inhibitory eytokine - 1 level in diangnosis for gastric cancer

目的 检测胃癌患者血清巨噬细胞抑制因子（Macrophage inhibitory cytokine-1,MIC-1）的浓度水平,并评估其在胃癌诊断中的应用价值.方法 用ELISA方法检测201例胃癌患者、58例胃炎患者及50名健康对照者血清MIC-1水平,同时测定癌胚抗原CEA、CA19-9.通过多因素Logistic回归分析,利用受试者工作特征（ROC）曲线分析MIC-1、CEA、CA19-9以及联合诊断对胃癌的诊断价值.结果 胃癌患者血清中MIC-1平均浓度为179.6pg/ml,高于单纯胃炎患者（46.3pg/ml）和健康对照（15.6 pg/ml）,差异均有显著统计学意义（P均〈0.05）.胃癌患者血清MIC-1的水平与患者性别、年龄、病理分化程度不相关.但胃癌患者血清MIC-1水平随着肿瘤分期的升高而升高,差异有显著统计学意义（P〈0.05）.伴有淋巴结转移胃癌患者MIC-1水平显著高于未转移者（P〈0.05）.浸润至浆膜外层的胃癌患者血清MIC浓度高于浸润至浆膜内层（P〈0.05）.根据ROC曲线分析,MIC-1检测胃癌的诊断效能高于CEA、CA19-9.MIC-1与CEA、CA19-9联合检测诊断价值显著高于单独指标检测（P〈0.05）.结论 胃癌患者血清中存在高水平的MIC-1,MIC-1与现有肿瘤标志物的联合检测可提高胃癌的诊断率.

Objective To evaluate the value of Maerophage inhibitory eytokine- 1 （MIC- 1） in the diagnosis of gastric malignancy. Method We detected serum MIC - 1 and investigated 201 patients with gastric cancer, and 58 patients with gastritis. For healthy controls, we obtained serum fl＇om 50 sex - matched blood donors within the same age range. The concentrations of CEA, CA19 - 9 also were detected. The multivariate logistic regression analysis and univariate receiver operating characteristic （ROC） analyses were done. Results The average MIC - 1 concentration （179 .tpg/ml） in gastric cancer patients was significantly higher than in gastritis patients （46.3 pg/ml） and healthy controls （15.6pg/ml）. The MIC - 1 levels were no significantly different for patients with sex, age and pathology differentiation （P 〉 0.05）. The levels of MIC - 1 were significantly higher for patients with a high TNM stages （ P 〈 0.05 ）, and tended to be higher in patients with positive lymph nodes and tumor infiltration （P 〈 0.05）. As the tumor biomarker for MIC - 1, the sensitivity and specificity of gastric cancer detection is higher than that CEA, CA19 - 9. The multivariate logistic regression analysis of MIC - 1, CEA and CA19 - 9 measured in the same sample set resulted in an area under the curve （AUG）, which was significantly higher than the AUC for either marker alone. Conclusion We conclude that MIC - 1 is a promising new biomarker for gastric cancer, and the combination of MIC - 1 and CEA, CA19 - 9 increase the sensitivity and specificity of detection of gastric cancer.