血清胱抑素C对结直肠组织良恶性病变诊断价值

The diagnostic value of serum cystatin C in benign and malignant colorectal lesions

[目的]探究血清胱抑素C(Cystatin C,Cys C)对结直肠组织良恶性病变的诊断价值。[方法]收集230例结直肠癌患者、209例结直肠息肉患者、117例健康体检者(健康对照组)血清,采用免疫比浊法检测3组受试者血清Cys C水平,比较3组血清Cys C水平并分析Cys C与肿瘤标志物之间的相关性。使用ROC曲线评价Cys C对结直肠癌的诊断价值,同时,分析血清Cys C与结直肠癌患者肿瘤分期、病理分化程度、淋巴结转移之间的关系。最后,比较结直肠癌患者术前、术后血清Cys C水平。[结果]结直肠癌血清Cys C水平高于结直肠息肉组和健康对照组[(0.85±0.12)mg/L vs.(0.75±0.12)mg/L vs.(0.67±0.06)mg/L],差异有统计学意义(P<0.05)。Cys C与CEA、CA199成正相关,相关系数为0.365、0.142(P<0.05)。血清Cys C的ROC曲线下面积为AUC=0.804,灵敏度和特异度为:84.3%和62.6%;Cys C的水平与结肠癌的分期、病理分化程度、淋巴结转移无关(P>0.05)。结直肠癌患者手术治疗后血清Cys C水平低于术前水平(P<0.05)。[结论]血清Cys C可作为结直肠癌的辅助诊断指标,有利于结直肠癌的早期诊断与预后判断。

[Objective]To explore the diagnostic value of serum cystatin C in benign and malignant colorectal tissue lesions.[Methods]Serum of 230 patients with colorectal cancer,209 patients with colorectal polyps,and 117 healthy subjects(healthy control group)were collected.The Cys C levels of the three groups of subjects were detected by the immunoturbidimetric method.Cys C levels of the three groups were compared and the correlation between Cys C and tumor markers was analyzed.ROC curve was used to evaluate the diagnostic value of Cys C for colorectal cancer.Meanwhile,the relationship between serum Cys C and tumor stage,pathological differentiation degree and lymph node metastasis of colorectal cancer patients was analyzed.Finally,serum Cys C levels were compared before and after operation in patients with colorectal cancer.[Results]Serum cystatin C level of colorectal cancer was higher than that of colorectal polyp group and healthy control group[(0.85±0.12)mg/Lvs.(0.75±0.12)mg/Lvs.(0.67±0.06)mg/L,t=114.6,P<0.05].Cys C was positively correlated with CEA and CA199,with correlation coefficients of 0.365 and 0.142(P<0.05).The area under the ROC curve of serum Cys C was AUC=0.804,and the sensitivity and specificity were 84.3%and 62.6%.The level of Cys C was not related to the stage,pathological differentiation and lymph node metastasis of colon cancer(P>0.05).After operation,the serum Cys C level was lower than that before operation(P<0.05).[Conclusion]serum cystatin C can be used as an auxiliary diagnostic index for colorectal cancer,which is more effective in the early diagnosis and prog-nosis of colorectal cancer.