C12多肿瘤标志物蛋白芯片在胃肠道癌诊断中的应用：329例手术患者的结果及改进建议

Application of C12 multi-tumor marker protein chip in the diagnosis of gastrointestinal cancer: results of 329 surgical patients and suggestions for improvement.

作者信息

Yang Xue-Qin, Yan Li, Chen Chuang, Hou Jin-Xuan, Li Yan

机构信息

Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center & Hubei Key Laboratory on Tumor Biological Behaviors, Wuhan, 430071, China.

出版信息

Hepatogastroenterology. 2009 Sep-Oct;56(94-95):1388-94.

PMID:19950797

Abstract

BACKGROUND/AIMS: Gastrointestinal (GI) cancer remains number one cancer killer in China. Serum tumor markers (TMs) are frequently used in the diagnosis of GI cancer. This study was to assess value of C12 multi-tumor marker protein chip diagnostic system developed in China in GI cancer.

METHODOLOGY

Sera from 329 GI cancer patients were detected by the C12 protein chip diagnostic system which consisted of 12 TMs including CEA, AFP, CA19-9, CA242, CA15-3, CA125, PSA, fPSA, NSE, B-HCG, HGH and Ferritin. The contribution of various TMs to the improvement of diagnosis was analyzed. The relationship between its positive rate and clinical stage, pathological type, and gender were explored.

RESULTS

The diagnostic rates were 13.73%, 33.33%, 38.30%, 58.03%, respectively, for stage I, II, III and IV patients, and the overall diagnostic rate was 39.21%. There were statistically significant differences in stage I versus stage III, stage I versus stage IV, and stage II versus stage IV (p < 0.01). The other stage comparisons did not reach statistical significance (p > 0.05). Among the 12 TMs of the protein chip, the top 3 positive rates of 27.36%, 19.76% and 19.45% were obtained from CEA, CA242 and CA19-9, respectively, which were correlated with stage of GI cancer. The combinations of 5 most relevant TMs (3, 4 or 5 markers combined) improve the diagnostic rate significantly comparison to CEA (p < 0.05 or p < 0.01)). The combination of CEA+CA19-9+f-PSA (35.71%) for male patients, and CEA+CA19-9+ CA125 (40.95%) for female patients almost got the same diagnostic value as the C12 protein chip diagnostic system did (38.39% for male, 40.95% for female).

CONCLUSIONS

The C12 system is of some value in the diagnosis of GI cancer, but new markers are needed to improve the early diagnosis. In GI cancer, the most rational combination way was CEA+CA19-9+f-PSA for male patient and CEA+CA19-9 +CA125 for female patient.

摘要

背景/目的：胃肠道（GI）癌仍是中国头号癌症杀手。血清肿瘤标志物（TMs）常用于GI癌的诊断。本研究旨在评估中国研发的C12多肿瘤标志物蛋白芯片诊断系统在GI癌中的价值。

方法

采用由癌胚抗原（CEA）、甲胎蛋白（AFP）、糖类抗原19-9（CA19-9）、糖类抗原242（CA242）、糖类抗原15-3（CA15-3）、糖类抗原125（CA125）、前列腺特异抗原（PSA）、游离前列腺特异抗原（fPSA）、神经元特异性烯醇化酶（NSE）、β-人绒毛膜促性腺激素（β-HCG）、生长激素（HGH）和铁蛋白这12种TMs组成的C12蛋白芯片诊断系统，对329例GI癌患者的血清进行检测。分析各种TMs对诊断改善的贡献。探讨其阳性率与临床分期、病理类型及性别的关系。

结果

I、II、III和IV期患者的诊断率分别为13.73%、33.33%、38.30%、58.03%，总体诊断率为39.21%。I期与III期、I期与IV期、II期与IV期之间存在统计学显著差异（p < 0.01）。其他分期比较未达到统计学显著性（p > 0.05）。在蛋白芯片的12种TMs中，CEA、CA242和CA19-9的阳性率分别为27.36%、19.76%和19.45%，位列前三，且与GI癌分期相关。5种最相关TMs的组合（3、4或5种标志物联合）与CEA相比，显著提高了诊断率（p < 0.05或p < 0.01）。男性患者CEA+CA19-9+f-PSA组合（35.71%）和女性患者CEA+CA19-9+CA125组合（40.95%）的诊断价值几乎与C12蛋白芯片诊断系统相同（男性为38.39%，女性为40.95%）。