壳多糖酶3样蛋白l联合相关标志物检测在胰腺癌诊断中的应用

Detection of chitinase 3-like 1 combined with other biomarkers for diagnosis of pancreatic cancer

目的评估检测血清壳多糖酶3样蛋白l(CHI3L1)、CA199、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDLC)、补体3(C3)、补体4(C4)代谢水平在胰腺癌临床诊断中的应用价值,以期筛选最优的胰腺癌诊断模型。方法收集101例患者血清,包括70例胰腺癌患者及31名健康对照。分别测定血清中CHI3L1、CA199、C3、C4及HDL-C、LDL-C代谢水平,对结果进行统计分析。结果胰腺癌患者血清中CHI3L1、CA199、C3、C4、HDL-C、LDL-C的水平显著高于正常人(P<0.05);胰腺癌患者血清中CHI3L1的水平与患者是否接受抗肿瘤治疗具有显著性差异(P<0.05),而与性别、年龄及是否转移等临床病理特征无明显差异(P>0.05);ROC曲线表明:血清CHI3L1、CA199、C3、C4、HDL-C、LDL-C水平对胰腺癌均具有一定的诊断价值;多指标联合分析提示:联合检测血清CHI3L1、CA199、C3、HDL-C(AUC=0.964)与CA199(AUC=0.896)及CA199、C3、HDL-C多因素联合检测(AUC=0.923)比较具有更高的诊断价值(P<0.05)。结论血清中CHI3L1、CA199、C3、C4、HDL-C、LDL-C表达水平对胰腺癌均具有一定的诊断价值;而CHI3L1、CA199、C3、HDL-C联合检测可作为胰腺癌最优的诊断模型。

Objective To assess the value of chitinase 3-like 1（CHI3 L1） alone or in combination with other biomarkers in the diagnosis of pancreatic cancer.Methods Serum samples were collected from 70 patients with pancreatic cancer and 31 healthy subjects and the levels of CHI3 L1,CA199,C3,C4,high-density lipoprotein cholesterol（HDL-C）,and low-density lipoproteincholesterol（LDL-C） in serum were detected.Results The serum samples from pancreatic cancer patients showed significantly higher CHI3 L1,CA199,C3,C4,HDL-C,and LDL-C levels than those from healthy subjects（P〈0.05）.In patients with pancreatic cancer,serum CHI3 L1 level was significantly correlated with the administration of anti-cancer therapy（P〈0.05）,but not with gender,age,metastasis or other clinicopathological parameters（P〈0.05）.ROC curve analysis showed that serum CHI3 L1,CA199,C3,C4,HDL-C,and LDL-C all had diagnostic value for pancreatic cancer.Multivariate analysis suggested that the combined detection model of CHI3 L1,CA199,C3,and HDL-C（AUC=0.964） had a greater diagnostic value than CA199（AUC=0.896） alone and the combined detection model consisting of CA199,C3,and HDL-C（AUC=0.923;P〈0.05）.Conclusion Serum levels of CHI3 L1,CA199,C3,C4,HDL-C,and LDL-C all have diagnostic value for pancreatic cancer,and the combined model consisting of CHI3 L1,CA199,C3,and HDL-C have greater diagnostic efficacy than the other biomarkers either alone or in combination.