血清Sema4C在结直肠癌患者的差异表达及临床意义

Differential expression and clinical significance of serum Sema4C in patients with colorectal cancer

目的观察结直肠癌患者(colorectal cancer,CRC)中脑信号蛋白4C(semaphorin 4C,Sema4C)表达水平与临床病理特征之间的联系,探讨其在CRC血清中的临床意义。方法通过UALCAN数据库分析Sema4C在CRC组织及正常组织中的表达水平。选取38例的CRC患者作为CRC组,另选取37例健康体检者作为对照组;采集两组研究对象静脉血,采用ELISA法检测两组血清Sema4C水平。收集CRC患者年龄、性别比例、肿瘤位置、肿瘤大小、分化程度、TNM分期、神经及脉管侵犯等临床病理资料,比较不同临床特征CRC患者血清Sema4C水平。绘制受试者ROC曲线,评估血清Sema4C水平对CRC的诊断效能。结果UALCAN数据库显示在CRC组织中Sema4C高于正常组织。通过临床样本发现CRC患者血清Sema4C的相对表达水平[1.510(0.814~3.452)ng/mL]明显高于健康体检者[0.993(0.677~1.995)ng/mL]血清Sema4C的相对表达水平(Z=2.194,P<0.05);肿瘤最大直径≥3 cm者血清Sema4C水平[1.702(0.860~4.242)ng/mL]高于<3 cm者[0.727(0.528~1.294)ng/mL](Z=-2.224,P=0.026);CRCT3+T4者血清Sema4C水平[1.766(0.853~4.530)ng/mL]高于T1+T2者[0.846(0.489~1.202)ng/mL](Z=-2.442,P=0.015),有神经侵犯者血清Sema4C水平[3.661(1.111~9.830)ng/mL]高于无神经侵犯者[1.395(0.727~1.956)ng/mL](Z=2.398,P=0.016)。而在不同年龄、性别、肿瘤部位、有无脉管侵犯及淋巴结转移患者之间差异均无统计学意义(P>0.05)。当血清Sema4C水平的最佳截断值为1.257时,其诊断CRC的ROC曲线下面积为0.674(95%CI:0.523~0.771,P=0.028),其诊断CRC的灵敏度为60.50%,特异度为70.30%。结论Sema4C在CRC患者血清中高表达,并且Sema4C蛋白水平的升高与CRC患者的肿瘤大小、T分期及神经侵犯密切有关,提示其对CRC诊断有一定价值。

Objective To observe the relationship between semaphorin 4C(Sema4C)expression and clinicopathological features in patients with colorectal cancer(CRC),and to explore its clinical significance in serum of CRC patients.Methods The expression levels of Sema4C in CRC tissues and normal tissues were analyzed by UALCAN database.Thirty-eight patients with CRC were selected as the colorectal cancer group,and thirty-seven healthy subjects were selected as the control group.Venous blood was collected from two groups,and Sema4C levels of both groups were detected by ELISA.The clinicopathological data of CRC patients including age,gender ratio,tumor location,tumor size,differentiation degree,TNM stage,nerve and vascular invasion were collected.And Sema4C levels in CRC patients with different clinical characteristics were compared.ROC curve was drawn to evaluate the diagnostic efficacy of Sema4C level in CRC.Results UALCAN database showed that Sema4C level was higher in CRC tissues than that in normal tissues.The relative expression level of Sema4C in CRC patients[1.510(0.814~3.452)ng/mL]was significantly higher than that in healthy subjects[0.993(0.677~1.995)ng/mL](Z=2.194,P<0.05).The Sema4C level in patients with tumor maximum diameter≥3 cm[1.702(0.860~4.242)ng/mL]was higher than that in patients with tumor maximum diameter<3 cm[0.727(0.528~1.294)ng/mL](Z=-2.224,P=0.026).The Sema4C level in CRCT3+T4 patients[1.766(0.853~4.530)ng/mL]was higher than that in T1+T2 patients[0.846(0.489~1.202)ng/mL](Z=-2.442,P=0.015).The serum Sema4C level in patients with nerve invasion[3.661(1.111~9.830)ng/mL]was higher than that in patients without nerve invasion[1.395(0.727~1.956)ng/mL](Z=2.398,P=0.016).There was no significant difference among patients with different age,different gender,different tumor location,with or without vascular invasion and lymph node metastasis(P>0.05).When the optimal cut-off value of serum Sema4C level was 1.257,the area under the ROC curve for the diagnosis of CRC was 0.674(95%CI:0.523~0.771,P=0.028);Its sensitivity for diagnosing CRC was 60.50%,and the specificity was 70.30%.Conclusion Sema4C is highly expressed in the serum of CRC patients.In addition,the increase of Sema4C protein level is closely related to the tumor size,T staging and nerve invasion in CRC patients,suggesting that Sema4C protein has certain value in the diagnosis of CRC.