血清透明质酸和层粘连蛋白作为上消化道癌症的潜在肿瘤标志物。

Serum hyaluronic acid and laminin as potential tumor markers for upper gastrointestinal cancers.

机构信息

Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Eur J Intern Med. 2012 Jan;23(1):58-64. doi: 10.1016/j.ejim.2011.07.018. Epub 2011 Aug 27.

DOI:10.1016/j.ejim.2011.07.018

PMID:22153533

Abstract

BACKGROUND

Early diagnosis of patients with upper gastrointestinal cancer is important because many cases are diagnosed in advanced stages and have poor prognosis. Several studies have reported increased serum levels of hyaluronic acid and laminin in various cancers and the correlation of the levels with poor prognosis. However, little data on the use of serum hyaluronic acid and laminin levels for early detection of esophageal and gastric cancers are available.

METHODS

We assessed serum hyaluronic acid and laminin levels using enzyme-linked immunosorbent assay in 20 gastric cardia cancer, 23 gastric noncardia cancer and 20 esophageal squamous cell carcinoma incident cases and 25 controls in the Golestan Province, northern Iran, a high risk area for upper gastrointestinal cancers.

RESULTS

Mean serum hyaluronic acid and laminin concentrations in cancer cases were higher than in controls in crude analyses. Significant correlations were observed between hyaluronic acid levels and gastric noncardia cancer (Beta-coefficient=0.390; P=0.01) and esophageal squamous cell carcinoma (Beta-coefficient=0.332; P=0.05) and between laminin levels and gastric cardia cancer (Beta-coefficient=0.454; P=0.003) in multivariate models. For esophageal squamous cell carcinoma, gastric cardia cancer, and gastric noncardia cancer, area under ROC curve (AUC) of hyaluronic acid was 0.708, 0.694, and 0.770, and of laminin was 0.706, 0.828, and 0.671.

CONCLUSIONS

Our study suggests that hyaluronic acid and laminin may be used to identify potentially high-risk groups of upper gastrointestinal cancers for further diagnostic work-ups, particularly in high incidence areas. Nevertheless, further studies with larger sample size and tumor staging information are warranted to clarify the clinical significance of hyaluronic acid and laminin in those cancers.

摘要

背景

早期诊断上消化道癌症患者非常重要，因为许多病例在晚期诊断，预后较差。几项研究报告称，在各种癌症中，血清透明质酸和层粘连蛋白水平升高，并与不良预后相关。然而，关于使用血清透明质酸和层粘连蛋白水平早期检测食管癌和胃癌的数据较少。

方法

我们在伊朗北部戈尔斯坦省（上消化道癌症高发地区）评估了 20 例贲门癌、23 例非贲门胃癌和 20 例食管鳞状细胞癌的发病病例和 25 例对照者的血清透明质酸和层粘连蛋白水平，这些病例均采用酶联免疫吸附试验检测。

结果

在粗分析中，癌症病例的血清透明质酸和层粘连蛋白浓度均高于对照组。在多变量模型中，透明质酸水平与非贲门胃癌（Beta 系数=0.390；P=0.01）和食管鳞状细胞癌（Beta 系数=0.332；P=0.05）显著相关，层粘连蛋白水平与贲门癌（Beta 系数=0.454；P=0.003）显著相关。对于食管鳞状细胞癌、贲门癌和非贲门胃癌，透明质酸的 ROC 曲线下面积（AUC）分别为 0.708、0.694 和 0.770，层粘连蛋白的 AUC 分别为 0.706、0.828 和 0.671。