血清可溶性细胞毒T淋巴细胞相关抗原-4在胃癌早期诊断中价值

Clinical value of serum soluble cytotoxic T lymphocyte associated antigen-4 to the early diagnosis of gastric cancer

目的探讨胃癌患者可溶性细胞毒T淋巴细胞相关抗原-4(soluble cytotoxic T lymphocyte associated antigen-4,sCTLA-4)表达情况及其对胃癌的诊断价值。方法胃癌患者63例(胃癌组)、慢性萎缩性胃炎患者15例(胃炎组)、胃溃疡患者12例(胃溃疡组)、体检健康者24例(对照组),采用ELISA法检测4组血清sCTLA-4水平,电化学发光法检测癌胚抗原(carcino-embryonic antigen,CEA)和糖类抗原72-4(carbohydrate antigen 72-4,CA72-4)水平,ROC曲线评价sCTLA-4单独及与CEA,CA72-4联合检测在胃癌诊断中的应用价值。结果胃癌组血清sCTLA-4,CEA及CA72-4水平明显高于胃炎组、胃溃疡组及对照组(P<0.05),胃炎组与胃溃疡组血清sCTLA-4水平明显高于对照组(P<0.05),胃炎组与胃溃疡组血清sCTLA-4水平比较差异无统计学意义(P>0.05),胃炎组、胃溃疡组与对照组血清CEA及CA72-4水平比较差异均无统计学意义(P>0.05);胃癌组血清sCTLA-4水平在临床分期与淋巴结转移上差异有统计学意义(P<0.05);sCTLA-4诊断胃癌的AUC为0.618,临界值为8.31ng/mL,灵敏度和特异度分别为72.4%,79.3%,与CEA及CA72-4联合检测诊断胃癌的AUC为0.835,灵敏度和特异度分别为88.9%,94.2%。结论胃癌患者sCTLA-4表达明显升高,其对胃癌早期诊断有重要价值。

Objective To explore the expression of serum soluble cytotoxic T lymphocyte associated antigen-4 （sCTLA- 4） in patients with gastric cancer and its diagnostic value. Methods The level of serum sCTLA-4 was measured by ELISA techique and electrochemiluminescence was used to detect carcino embryonic antigen （CEA） and carbohydrate antigen 72-4 （CA72-4） in 63 patients with gastric cancer （cancer group）, 15 patients with chronic atrophic gastritis （gastritis group）, 12 patients with gastric ulcer （ulcer group） and 24 healthy controls （control group）. The diagnostic values of sCTLA-4 alone and the combination of CEA and CA72-4 were evaluated by ROC curve. Results The serum sCTLA-4, CEA and CA72 4 levels were significantly higher in cancer group than those in gastritis group, ulcer group and control group （P〈0.05）. The sCTLA-4 level was significantly higher in gastritis group and ulcer group than that in control group （P〈0.05）. There was no significant difference in sCTLA 4 between gastritis group and ulcer group （P〉 0.05）. There were no significant differences in CEA and CA72-4 levels in gastritis group and gastric ulcer compared with control group （P〉0.05）. There was a significant difference in sCTLA 4 level in clinical stage and lymph metastasis in gastritis group （P〈0.05）. The AUC of sCTLA-4 for gastric cancer diagnosis was 0. 618, and the cut-off value was 8.31 ng/mL. The sensitivity and specificity were 72.40% and 79.30% respectively. The AUC of sCTLA-4 combined with CEA and CA72-4 was 0. 835, and the sensitivity and specificity were 88. 9% and 94. 2% respectively. Conclusion The sCTLA-4 level increases obviously in patients with gastric cancer and has an important value to the early diagnosis of gastric cancer.