Knychalski Bartłomiej, Lukieńczuk Tadeusz
First Department and Clinic of General, Gastroenterological and Endocrinological Surgery, Medical University in Wrocław.
Pol Przegl Chir. 2012 Feb;84(2):86-92. doi: 10.2478/v10035-012-0014-3.
Finding the biomarker or biomarkers with high sensitivity and specificity in colorectal cancer, and thus a high diagnostic value will determine their clinical usefulness in clinical practice. An effective noninvasive blood test would be an ideal method to detect colorectal cancer. Discovered in 2007 a novel tumor marker CCSA-2 showes a promising results in patients with colorectal cancer. THE AIM OF THE STUDY was the evaluation of diagnostic and clinical value of a novel marker - colon cancer specific antigen-2 (CCSA-2) in colorectal adenocarcinoma in comparison to carcinoembryonic antigen (CEA) in patients operated during the years 2008 to 2010 at Wrocław Medical University 1st Department and Clinic of General, Gastroenterological and Endocrinologic Surgery.
The study was performed on 40 patients with colorectal cancer and 40 patients in control group consisted of healthy subjects who had colonoscopy examinations with negative results (no pathology in the colon was found). The obtained results were statistically analyzed using nonparametric tests - Mann Whitney U and Kruskal-Wallis and Spearman's rank correlation coefficients. To determine the clinical value of CCSA-2 and CEA in those groups, their sensitivity and specifity was evaluated using ROC analysis. This analysis determines the accuracy and diagnostic value of both tests.
There was a positive correlation between markers in patients with colorectal cancer and a statistically significant relationship according to which respondents with higher concentrations of CCSA-2 also have higher concentrations of CEA (R=0.754, p<0,001). Concentrations of tumor markers increase and correlate with the clinical progression of the disease. Accuracy of CCSA-2 test using ROC analysis showed a slightly lower measurement of antigen CCSA-2 as diagnostic value in colorectal cancer in comparison to measurement of antigen CEA (accuracy of tests: CCSA-2 - 52%, CEA - 60%).
CCSA-2 as a single tumor marker has a low diagnostic value in colorectal cancer because of low sensitivity and specifity. The diagnostic value of novel marker is slightly lower than previously understood and accepted in clinical practice - CEA.
在结直肠癌中找到具有高灵敏度和特异性的生物标志物,从而具有高诊断价值,将决定它们在临床实践中的临床实用性。一种有效的非侵入性血液检测将是检测结直肠癌的理想方法。2007年发现的一种新型肿瘤标志物CCSA - 2在结直肠癌患者中显示出有前景的结果。本研究的目的是评估一种新型标志物——结肠癌特异性抗原 - 2(CCSA - 2)在2008年至2010年期间于弗罗茨瓦夫医科大学第一普通、胃肠和内分泌外科进行手术的患者的结直肠腺癌中的诊断和临床价值,并与癌胚抗原(CEA)进行比较。
该研究对40例结直肠癌患者和40例对照组患者进行,对照组由结肠镜检查结果为阴性(结肠未发现病变)的健康受试者组成。使用非参数检验——曼 - 惠特尼U检验、克鲁斯卡尔 - 沃利斯检验和斯皮尔曼等级相关系数对获得的结果进行统计分析。为了确定CCSA - 2和CEA在这些组中的临床价值,使用ROC分析评估它们的敏感性和特异性。该分析确定了两种检测的准确性和诊断价值。
结直肠癌患者中标志物之间存在正相关,且具有统计学意义的关系,即CCSA - 2浓度较高的受试者CEA浓度也较高(R = 0.754,p < 0.001)。肿瘤标志物的浓度随着疾病的临床进展而增加并与之相关。使用ROC分析,CCSA - 2检测的准确性显示,与CEA抗原测量相比,CCSA - 2抗原作为结直肠癌诊断价值的测量略低(检测准确性:CCSA - 2 - 52%,CEA - 60%)。
CCSA - 2作为单一肿瘤标志物在结直肠癌中的诊断价值较低,因为其敏感性和特异性较低。这种新型标志物的诊断价值略低于临床实践中先前理解和接受的CEA。