胃癌患者血清中可溶性LAG-3分子的水平及意义

Expression and significance of soluble LAG-3 in the serum of the patients with gastric cancer

目的检测可溶性LAG-3(soluble LAG-3,sLAG-3)在胃癌患者血清中的水平及其诊断价值。方法用ELISA法检测92例胃癌患者及50例体检健康者血清中sLAG-3的含量,并分析胃癌患者血清sLAG-3水平与临床病理特征之间的关系。用ROC曲线分析sLAG-3作为胃癌诊断标志物的价值。电化学发光法检测标本的CEA表达水平,比较两者的诊断效率。结果胃癌患者血清sLAG-3含量的中位数(四分位数间距)为137.1(78.2,356.8)ng/mL,显著低于健康对照组血清的711.4(504.8,1 089.4)ng/mL(Z=7.513,P<0.01)。胃癌患者血清sLAG-3含量与肿瘤分期、分化程度及浸润深度均有显著相关(Z分别为2.196,2.167和2.022,P均<0.05),而与其他临床病理特征无关。sLAG-3诊断胃癌中的敏感性(75.00%)和准确性(81.7%)均高于CEA(16.3%和43.7%)。结论 sLAG-3可作为胃癌诊断的潜在血清标志物。

Objective：To investigate the level and diagnostic value of soluble LAG-3 （sLAG-3） in the serum of the patients with gastric cancer. Methods：The levels of sLAG-3 in the serum samples from 92 patients with gastric cancer and 50 healthy controls were detected by ELISA, and the correlation between the level of sLAG-3 and clinical pathological feature in the gastric cancer patients was also analyzed. The diagnostic value of sLAG-3 as a marker for the diagnosis of gastric cancer was assessed by ROC curve. Meanwhile, the CEA levels of the patients were determined by the electrochemiluminescence and its diagnostic efficiency was compared with that of sLAG-3. Results：The median （interquartile range） of sLAG-3 in the serum of the patients with gastric cancer [137.06 （78.18, 356.79） ng/mL] was significantly lower than that of healthy controls [711.43 （504.82, 1 089.39） ng/mL, Z=7.513, P〈0.01]. The level of sLAG-3 in the serum of gastric cancer patients was positively correlated with the stage, differentiation and the depth of invasion of the tumor （all P〈0.05）. The sensitivity （75.00%） and accuracy （81.69%） of sLAG-3 for the diagnosis of gastric cancer were significantly higher than that of CEA （16.30% and 43.66%）. Conclusion：sLAG-3 may be regarded as a candidate serum marker for the diagnosis of gastric cancer.