血清TK1在健康体检筛查中预测癌前疾病发生的研究

The clinical significance of serological screening of TK1,AFP,CEA and PSA in health physical examination population in predicting precancerous change

目的探讨胸苷激酶1(TK1)、甲胎蛋白(AFP)、癌胚抗原(CEA)和前列腺特异性抗原(PSA)在临界值以下,对癌前疾病的预测意义。方法测定TK1、AFP、CEA和PSA的平均值和浓度分布。健康筛查组(n=55750),包括非肿瘤疾病、恶性肿瘤和与恶性肿瘤风险相关的疾病人群。健康无病组(n=428)作为对照。结果健康筛查组(TK1<2pM)中,部分人群(51.6%)呈近似正常浓度分布,部分人群(43.9%)较健康无病组轻度升高。由于分布广泛,在临界值以下的人群中,TK1平均值从健康无病组的(0.38±0.30)pM显著增加到健康筛查组的(0.69±0.55)pM,2组差异有统计学意义(P=0.01)。性别和年龄中TK1浓度分布差异无统计学意义(P>0.05)。AFP、CEA、PSA的均值及分布在性别及年龄2组间差异无统计学意义(P>0.05)。相比健康无病组,健康筛查组在临界值以下升高的TK1与肝脏及前列腺的癌前疾病和肿瘤风险发展相关,而AFP、CEA和PSA无此相关性。结论TK1是一种潜在的生物增殖标志物,可用于早期发现具有潜在或已经具有恶性肿瘤风险相关的癌前疾病或恶性肿瘤风险的人群。

Objective To investigate the clinical significance of serological screening of TK1 protein(TK1),alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),prostate specific antigen(PSA) in health physical examination population in predicting precancerous change. Methods The mean values and concentration distribution of TK1,AFP,CEA and PSA were determined in a cohort of 55,750 subjects(health screening group),including the subjects with non-tumor diseases,and the diseases related with malignant tumor or with the risk of malignant tumor,at the same time,the other 428 healthy subjects were served as control group. Results In health screening group(TK1 < 2 p M),the TK1 in part population(51. 6%) showed almost normal concentration distribution,which in the other part population(43. 9%) was slightly increased,as compared with that in control group. Because of the extensive distribution,the mean value of TK1 in the population under critical value in health screening group was increased significantly,as compared with that in control group[0. 69 ± 0. 55) p M vs(0. 38 ± 0. 30) p M,P < 0. 01]. However there were no significant differences in the concentration distribution and the mean values of TK1 in different genders and ages(P > 0. 05). As compared with that in control group,the TK1 increase in the subjects under critical value was correlated with precancerous change of liver and prostate as well as the risk of tumorigenesis,however,AFP,CEA and PSA were not correlated with these factors. Conclusion TK1 is a potential proliferating biomarker for early discovering the population with the risk to develop tumors or already have precancerous change.