摘要
目的 探讨结直肠癌患者(CRC)血清载脂蛋白的表达变化及诊断价值。方法 选取2021年5月至2022年1月于上海交通大学医学院附属仁济医院就诊的108例CRC患者作为CRC组,以及82例炎性肠病患者作为IBD组,48例肠道息肉患者作为ISP组,50例急性胃肠炎患者作为AGE组(IBD组、ISP组、AGE组患者均纳入疾病对照组);另选取100例体检健康志愿者作为健康对照组(HC组)。比较各组血清载脂蛋白(Apo)A1、ApoA2、ApoB、ApoC2、ApoC3、ApoE水平,以及癌胚抗原(CEA)、糖类抗原(CA)19-9、CA242、CA50、CA72-4这5项肿瘤标志物水平。采用二元Logistic回归法对各指标进行拟合并建立风险模型,采用受试者工作特征(ROC)曲线分析各指标对CRC的诊断效能。结果 与HC组相比,CRC组血清ApoA1、ApoA2、ApoB、ApoC2、ApoC3、ApoE水平较低(P<0.05);与IBD组相比,CRC组血清ApoA1、ApoA2水平较低(P<0.05),ApoB、ApoC2、ApoE水平较高(P<0.05);与ISP组相比,CRC组血清ApoA1、ApoA2、ApoC3、ApoE水平较低(P<0.05);与AGE组相比,CRC组血清ApoA1、ApoA2水平较低(P<0.05),ApoC2水平较高(P<0.05)。所有单项指标中,ApoA2的诊断效能最高,曲线下面积(AUC)为0.787,灵敏度为83.33%,特异度为60.71%;ApoA1、ApoA2、CEA三项指标联合预测CRC的诊断效能高于单项指标,AUC为0.876,灵敏度为74.07%,特异度为87.86%。结论 CRC患者血清载脂蛋白通常存在表达异常,ApoA1、ApoA2、CEA三项指标联合预测对CRC的辅助诊断有一定的参考价值。
Objective To investigate the changes of serum apolipoprotein expression in patients with colorectal cancer(CRC)and its diagnostic value.Methods A total of 108 CRC patients admitted to Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2021 to January 2022 were selected as CRC group.In addition,82 patients with inflammatory bowel disease were enrolled as the IBD group,48 patients with intestinal polyps were enrolled as the ISP group,and 50 patients with acute gastroenteritis were enrolled as the AGE group.IBD group,ISP group and AGE group were enrolled as disease control group.Another 100 healthy volunteers were selected as healthy control group(HC group).Serum levels of apolipoprotein(ApoA)1,ApoA2,ApoB,ApoC2,ApoC3,ApoE,and five tumor markers,CEA,CA19-9,CA242,CA50 and CA72-4 were compared among all groups.Binary Logistic regression was used to fit and combine all indicators to establish a risk model,and receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of each indicator for CRC.Results Compared with HC group,serum levels of ApoA1,ApoA2,ApoB,ApoC2,ApoC3 and ApoE in CRC group were significantly lower(P<0.05).Compared with IBD group,serum ApoA1 and ApoA2 levels in CRC group were significantly lower(P<0.05),while serum ApoB,ApoC2 and ApoE levels were significantly higher(P<0.05).Compared with ISP group,serum ApoA1,ApoA2,ApoC3,ApoE levels in CRC group were significantly lower(P<0.05).Compared with AGE group,serum ApoA1 and ApoA2 levels in CRC group were significantly lower(P<0.05),while serum ApoC2 level was significantly higher(P<0.05).Among all the single indicator,ApoA2 had the highest diagnostic efficiency,with area under curve(AUC)of 0.787,sensitivity of 83.33%and specificity of 60.71%.The combined predictive efficacy of ApoA1,ApoA2 and CEA were higher than those of single indicator,with AUC of 0.876,sensitivity of 74.07%and specificity of 87.86%.Conclusion Serum apolipoprotein expression is usually abnormal in CRC patients.The combined prediction of ApoA1,ApoA2 and CEA has certain reference value for the auxiliary diagnosis of CRC.
作者
徐润灏
邹琛
陈风
刘怡菁
张洁
曹芸
XU Runhao;ZOU Chen;CHEN Feng;LIU Yijing;ZHANG Jie;CAO Yun(Department of Clinical Laboratory,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China;Department of Clinical Laboratory,Children′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200062,China)
出处
《国际检验医学杂志》
CAS
2023年第10期1235-1239,1244,共6页
International Journal of Laboratory Medicine
