血清MCP-1在结直肠癌肝脏转移诊断及预后判断中的作用

Role of Serum MCP-1 on Diagnosis and Prognosis in Colorectal Liver Metastases

[目的]检测单核细胞趋化蛋白1(MCP-1)在结直肠癌患者血清中的含量,分析其在结直肠癌患者肝脏转移诊断和预后判断中的应用潜力和价值。[方法]采用ELISA方法定量检测60例健康人员及155例有随访资料的结直肠癌患者血清MCP-1水平,采用SPSS17.0软件进行数据检测分析。[结果]结直肠癌患者血清MCP-1平均水平为260.7±111.4pg/ml,明显高于正常人血清中的188.4±80.4pg/ml(P<0.001)。在结直肠癌组中发生肝脏转移的患者血清MCP-1平均水平为347.7±118.7pg/ml,显著高于无肝脏转移患者平均水平228.4±89.6pg/ml(P<0.001)。Kaplan-Meier生存分析显示,血清MCP-1低表达患者(<251.9pg/ml)的中位生存期为53个月,而血清MCP-1高表达患者(>251.9pg/ml)的中位生存期仅为46个月;前者的3年总生存率为87.9%,而后者仅为54.7%(P<0.001)。Cox比例风险回归模型分析显示,血清MCP-1水平可作为判断结直肠癌患者预后的独立因素(HR=1.528,95%CI:1.093～2.135;P=0.013)。[结论]结直肠癌患者血清MCP-1水平明显高于正常人。发生肝脏转移的结直肠癌患者血清MCP-1水平明显高于无肝脏转移患者。血清MCP-1在结直肠癌及其肝脏转移诊断中具有作为辅助诊断指标的应用潜力。同时血清MCP-1可作为结直肠癌患者预后判断的独立因素,具有重要的临床应用价值。

[Purpose] To detect serum monocyte ehemoattractant protein-1（MCP-1） level and analyze whether it is an independent diagnosis and prognostic factor in colorectal cancer with liver metastases. [Methods] A total of 155 patients diagnosed with colorectal cancer （CRC） and 60 healthy controls comprised our cohort. Preoperatively obtained serum samples were analyzed for levels of MCP-1 by ELISA. [Results] ELISA re- vealed significant higher serum concentrations of MCP-I in CRC patients （260.7±111.4pg/ml） compared to those in healthy individuals（188.4±80.4pg/ml）（P〈0.001 ）. Meanwhile, CRC patients with liver metastases had significant higher serum MCP-1 levels （347.7±118.7pg/ml） than those without liver metastases （228.4± 89.6pg/ml）（P〈0.001）. Elevated serum MCP-1 level significantly correlated with a poorer progress free sur- vival （P〈0.001）.The median PFS of patients with elevated serum MCP-1 level was 46 months（95%CI：25.4- 51.6 months）,whereas that of patients with normal serum MCP-1 level was 53 months （95%CI：52.6-53.5 months）.In multivariate regression analysis,serum MCP-1 level was an independent predictor for OS in pa- tients with colorectal cancer（hazard ratio= 1.528,95%CI： 1.093N2.135 ; P=0.013）. [ Conclusions ] Serum MCP- 1 level in patients with colorectal cancer is much higher than that in healthy person. It is also higher in pa- tients with liver metastases than that without liver metastases. MCP-1 seems to be a promising factor to di- agnose colorectal cancer and predict the outcome of these patients