结直肠癌患者血清ANGPTL2水平及其临床诊断价值研究

Serum ANGPTL2 Level in Patients with Colorectal Cancer and Its Clinical Diagnostic Value

目的检测结直肠癌(colorectal cancer,CRC)患者血清血管生成素样蛋白2(angiopoietin-like protein 2,ANGPTL2)水平,探讨ANGPTL2用于CRC诊断的临床价值。方法回顾性纳入2011年2月~2015年4月在笔者医院肿瘤科就诊的初治CRC患者80例(CRC组),同时纳入健康对照32例。所有患者就诊时记录一般情况,常规检测癌胚抗原(carcinoembryonic antigen,CEA)及糖类抗原(carbohydrate antigen 19-9,CA19-9)。收集患者血清检测ANGPTL2水平,分析其与临床指标的相关性,并使用ROC曲线分析诊断价值。结果 CRC组ANGPTL2水平显著高于健康对照组,差异有统计学意义(2.95±0.54log10pg/ml vs 1.98±0.49log10pg/ml,P=0.000)。临床分期为Ⅳ期的CRC患者ANGPTL2(3.13±0.46log10pg/ml)较Ⅰ~Ⅲ期患者更高。CRC组ANGPTL2与CEA(R=0.684,P=0.000)、CA19-9(R=0.703,P=0.000)及临床分期(R=0.424,P=0.000)呈显著正相关。血清ANGPTL2用于CRC诊断的AUC为0.900(95%CI:0.843~0.957),ANGPTL2联合CEA由于CRC诊断的AUC为0.913(95%CI:0.862~0.964)。结论血清ANGPTL2在CRC患者中显著升高,作为无创诊断指标具有良好的诊断价值。

Objective To invetigate the level and diagnostic value of serum protein angiopoietin - like 2 （ANGPTL2） in patients with colorectal carcinoma （CRC）. Methods A total of 80 patients with CRC （ CRC group） in our hospital from February 2011 to April 2015 were enrolled retrospectively, and 32 healthy patients were as the control. The general situations, carcinoembryonic antigen （CEA） and carbohydrate antigen 19- 9 （CA19- 9） were recorded. The serum ANGPTL2 in patients were tested, and the relationship between ANGPTL2 and clinical parameters was analyzed. The ROC curve was used to evaluate the diagnositc valve of ANGPTL2 in CRC patients. Results The level of ANGPTL2 in CRC group was significantly higher than those in control group （2.95 ＋ 0.54 log^opg/ml vs 1.98 ＋ 0.49 logl0pg/ml, P = 0. 000）. ANGPTL2 in patients with stage IV C RC （3.13 ＋ 0.46 loglopg/ml） was highest among all clinical stages （ stage I - IV ）. ANGPTL2 were significantly positive correlated with CEA （ R = 0. 684, P = 0. 000）, CA19 - 9 （ R = 0. 703, P = 0. 000） and clinical stage （R = 0. 424, P = 0. 000） in CRC group. AUC of ANGPTL2 used for CRC diagnosis was 0. 900 （95% CI： 0. 843 - 0. 957）, AUC of ANGPTL2 combined with CEA was 0. 913 （95% CI： 0. 862 -0. 964）. Conclusion Serum ANGPTL2 level in patients with CRC is significantly elevated, and it can be used as a noninvasive diagnostic biological marker.