结直肠癌患者血清富含半胱氨酸蛋白61水平及其临床诊断价值研究

Serum cysteine-rich protein 61 level in patients with colorectal cancer and its clinical diagnostic value

目的探讨血清富含半胱氨酸的血管生成诱导因子61(Cyr61)水平用于结直肠癌(CRC)患者辅助诊断的临床价值。方法回顾性纳入该院2014年2月至2017年10月就诊的初治CRC患者87例(CRC组),同时纳入结直肠腺瘤患者42例(结直肠腺瘤组)及体检健康者43例(健康对照组)。所有患者就诊时记录一般情况,检测血清Cyr61、癌胚抗原(CEA)及糖类抗原19-9(CA19-9)水平,使用受试者工作特征曲线(ROC曲线)评估Cyr61的诊断价值。结果CRC组Cyr61水平[(204.26±65.04)pg/mL]显著高于结直肠腺瘤组[(127.11±41.81)pg/mL]及健康对照组[(118.03±42.98)pg/mL],差异有统计学意义(P<0.05)。CRC组不同临床分期患者Cyr61水平由高至低为Ⅳ期[(243.28±69.28)pg/mL]、Ⅲ期[(207.39±57.85)pg/mL]、Ⅰ~Ⅱ期[(172.94±48.58)pg/mL]。CRC组患者血清Cyr61水平与CEA(r=0.473,P<0.05)及CA19-9(r=0.518,P<0.05)、TNM分期(r=0.482,P<0.05)呈显著正相关。区别诊断CRC与结直肠腺瘤时,Cyr61、CEA及CA19-9的ROC曲线下面积(AUC)分别为0.761、0.751及0.747,Cyr61+CEA+CA19-9的AUC为0.842;区别CRC与健康对照组时,Cyr61、CEA及CA19-9的AUC分别为0.866、0.831及0.818,Cyr61+CEA+CA19-9的AUC为0.924。结论血清Cyr61水平在CRC中存在显著升高,且Cyr61单独或联合常规指标用于CRC的筛查诊断具有良好的临床价值。

Objective To investigate the diagnostic value of serum cysteine-rich protein 61 （Cyr61） in pa- tients with colorectal carcinoma （CRC）. Methods A total of 87 patients with CRC （CRC group） from Febru ary 2014 to October 2017 were enrolled,and 42 colorectal adenomas patients （colorectal adenomas group） and 43 healthy people （healthy control group） were enrolled. The general situations were recorded,and the serum CEA,CA19-9 and Cyril1 levels were tested. The ROC curve was used to evaluate the diagnostic value of Cyr61 in CRC patients. Results The level of Cyr61 in CRC group [（204.26 ±65. 04）pg/mL] was significantly high er than those in colorectal adenomas group [（127. 11±41. 81）pg/mL] or healthy control group [（118. 03± 42.98）pg/mL], the difference was statistically significant （P〈0.05）. The Cyr61 levels from high to low were as followed：stage IV[（243. 284±69.28）pg/mL],stage Ⅲ[（207. 394±57.85）pg/mL],stage Ⅰ-Ⅱ（172. 944±48.58）pg,/mI] Cyr61 were significantly positive correlated with CEA （r=0. 473,P〈0.05）,CA19-9 （r= 0. 518,P〈0.05） and TNM stage （r=0. 482,P〈0. 05） in CRC group. When used to distinguish CRC from colorectal adenomas,AUC of Cyr61 ,CEA and CA19-9 were 0. 761,0. 751 and 0. 747 respectively,and the AUC of Cyr61 combined with CEA and CA19-9 was 0. 842. When used to distinguish CRC from healthy control, AUC of Cyr61 ,CEA and CA19-9 were 0. 866,0. 831 and 0. 818 respectively,and the AUC of Cyr61 combined with CEA and CA19-9 was 0. 924. Conclusion Serum Cyr61 level in patients with CRC was significantly ele- vated,and it can be well used for CRC diagnosis alone or combined with conventional parameters.