异常糖链糖蛋白不同截断值排查消化道肿瘤的效能

Efficacy of different cutoffs of abnormal glycan glycoproteins in the diagnosis of gastrointestinal tumors

目的探讨异常糖链糖蛋白(TAP)不同截断值排查消化道肿瘤(GITs)的效能。方法选取2018年1月至2019年12月嘉兴市第一医院健康管理中心的1192例体检者,其中恶性GITs患者263例、良性消化道疾病患者355例、健康人群574例,以121μm^(2)为分界值,统计TAP检出恶性GITs的灵敏度、特异度、准确率,比较不同恶性GITs类型患者TAP表达水平,采用ROC曲线及AUC分析TAP鉴别不同GITs类型肿瘤的血流凝聚物面积截断值、灵敏度、特异度,并比较不同TAP截断值范围各类型恶性GITs发生率及不同分期恶性GITs患者TAP表达水平。结果当截断值为121μm^(2)时,TAP诊断恶性GITs的灵敏度为89.35%,特异度为85.36%,准确率为86.24%;食管癌、胃癌、结直肠癌、对照组TAP表达水平依次降低,组间比较差异有统计学意义(P<0.05);TAP鉴别食管癌的AUC为0.825,最佳截断值为>281.79μm^(2)(P<0.05);TAP鉴别胃癌的AUC为0.816,截断值为>240.06μm^(2)(P<0.05);TAP鉴别结直肠癌的AUC为0.797,最佳截断值为>221.88μm^(2)(P<0.05);结直肠癌患者占比在TAP介于221.88~<240.06μm^(2)时最高,食管癌患者占比在TAP>281.79μm^(2)时最高,胃癌患者占比在TAP介于240.06~281.79μm^(2)时最高(P<0.05);随着肿瘤T分期的递增,TAP表达水平逐渐升高(P<0.05)。结论当截断值为121μm^(2)时,TAP排查恶性GITs的效能较高,且TAP表达水平>281.79、240.06、221.88μm^(2)时,可为临床鉴别不同类型恶性GITs提供量化参考。

Objective To investigate the efficacy of different cut-off values of abnormal glycan glycoprotein(TAP)in the diagnosis of gastrointestinal tumors(GITs).Methods From January 2018 to December 2019,1192 patients in our hospital medical examination center were selected,including 263 patients with malignant GITs,355 patients with benign gastrointestinal diseases,and 574 healthy people(control group),121μm^(2) was used as the cut-off value,the sensitivity,specificity,and accuracy of TAP detection and diagnosis of malignant GITs were calculated,compared the expression of TAP in patients with different malignant GITs,the receiver operating characteristic curve(ROC)and the area under the ROC(AUC)were used to analyze the cutoff value,sensitivity,and specificity of TAP to identify tumors with different GITs,and the incidence of malignant tumors of different GITs types in different TAP cut-off ranges and the expression of TAP in patients with different stages of malignant GITs were compared.Results When the cut-off value was 121μm^(2),the sensitivity of TAP to diagnose malignant GITs was 89.35%,the specificity was 85.36%,and the accuracy was 86.24%,the expression of TAP in esophageal cancer,gastric cancer,colorectal cancer,and control group decreased in order,and the differences between groups were statistically significant(P<0.05),the AUC of TAP to identify esophageal cancer was 0.825,and the best cutoff value was>281.79μm^(2)(P<0.05),the AUC of TAP to identify gastric cancer was 0.816,and the cutoff value was>240.06μm^(2)(P<0.05),the AUC of TAP to identify colorectal cancer was 0.797,and the best cutoff value was 221.88μm^(2)(P<0.05),the proportion of colorectal cancer patients was highest when TAP was between 221.88-<240.06μm^(2),the proportion of patients with esophageal cancer was highest when TAP>281.79μm^(2),the proportion of patients with gastric cancer was highest when TAP was between 240.06~281.79μm^(2)(P<0.05),with the in crease of tumor T stage,the expression of TAP gradually increased(P<0.05).Conclusion When the truncation value is 121μm^(2),the effectiveness of TAP in detecting malignant GITs is higher,when TAP>281.79,240.06,221.88μm^(2),it can pro-vide a quantitative reference for clinically identifying different types of malignant GITs.