胸苷激酶1、癌胚抗原和糖类抗原在结直肠肿瘤中的表达及临床意义

Expression and clinical significance of thymidine kinase 1,carcinoembryonic antigen and carbohydrate antigens in colorectal tumors

目的探讨胸苷激酶1(TK1)、癌胚抗原(CEA)、糖类抗原(CA)19-9、CA15-3和CA72-4在结直肠肿瘤中的表达及临床意义。方法采用酶联免疫吸附测定(ELISA)法和电化学发光免疫分析(ECLIA)法分别测定了124例结直肠癌患者、52例结直肠癌前病变患者、154例结直肠良性病变患者、106例健康体检者的血清TK1水平和血清CEA、CA19-9、CA15-3、CA72-4的水平。分析结直肠癌患者血清TK1和其临床病理特征之间的关系。探讨TK1、CEA、CA19-9、CA15-3和CA72-4单独检测与联合检测对结直肠癌的诊断效能。结果结直肠癌患者的血清TK1表达水平与肿瘤分期、分化程度、淋巴结转移、远端转移及年龄相关(均P<0.05),但与患者性别无关(P>0.05)。在结直肠癌、癌前病变、良性病变和健康者中,血清TK1水平依次降低。TK1高表达的结直肠癌患者,其生存期更短。多标志物的联合检测的敏感性、特异性和准确率分别为93.5%、93.0%和93.1%。结论血清TK1有望成为结直肠癌诊断及预后预测的独立标志物。TK1、CEA、CA19-9、CA15-3和CA72-4的联合检测具有结直肠癌诊断的临床意义。

Objective To investigate the expression and clinical significance of thymidine kinase 1(TK1),carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA15-3 and CA72-4 in colorectal tumors.Methods Enzyme-linked immunosorbent assay(ELISA)and electrochemiluminescence immuno assay(ECLIA)were used to determine the serum TK1 levels and serum CEA,CA19-9,CA15-3,CA72-4 levels in 124 patients with colorectal cancer,52 patients with colorectal precancerous lesions,154 patients with benign colorectal lesions,and 106 health subjects.The relationship between serum TK1 and its clinicopathological characteristics in patients with colorectal cancer were analyzed.The diagnostic efficacy of TK1,CEA,CA19-9,CA15-3 and CA72-4 alone and combined detection for colorectal cancer was investigated.Results The serum expression level of TK1 in patients with colorectal cancer was related to tumor stage,degree of differentiation,lymph node metastasis,distant metastasis and age(all P<0.05),but not related to the patient's gender(P>0.05).The serum TK1 level decreased sequentially in colorectal cancer patients,precancerous lesions patients,benign lesions patients and healthy subjects.Colorectal cancer patients with high TK1 expression have a shorter survival time.The sensitivity,specificity and accuracy of the combined detection of TK1,CEA,CA19-9,CA15-3 and CA72-4 were 93.5%,93.0%,and 93.1%,respectively.Conclusions Serum TK1 is expected to become an independent marker for the diagnosis and prognosis of colorectal cancer.The combined detection of TK1,CEA,CA19-9,CA15-3 and CA72-4 has clinical significance in the diagnosis of colorectal cancer.