[血清中性粒细胞明胶酶相关脂质运载蛋白检测在人类结直肠癌中的临床意义]

[Clinical significance of the detection of serum neutrophil gelatinase-associated lipocalin in human colorectal cancer].

作者信息

Ding Lei, Zhang Xiufeng, Zhang Yanxiang, Yang Guangen, Liao Xiujun, Shen Zhong, Qiu Jianming, Mao Weiming, Hu Lihua, Shao Shuxian, Shang Shanliang

机构信息

Department of General Surgery, The Third People's Hospital of Hangzhou City, Hangzhou Clinical School, Anhui Medical University, Hangzhou 310009, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Jun;17(6):589-93.

PMID:24953369

Abstract

OBJECTIVE

To explore the feasibility and clinical significance of the detection of serum neutrophil gelatinase-associated lipocalin (NGAL) in human colorectal cancer.

METHODS

Levels of NGAL in serum samples from 133 healthy people, 125 colorectal polyps patients and 100 colorectal cancer patients respectively were determined by sandwich ELISA assay. Relationship of NGAL level with clinicopathological features of colorectal cancer patients was analyzed. The optimal cut-off value of serum NGAL for diagnosing colorectal cancer was determined by ROC curve and compared with CEA and CA19-9. Univariate and multivariate analyses were performed to examine the relationship of NGAL level with the prognosis of patients with colorectal cancer.

RESULTS

The median serum NGAL protein level in 100 colorectal cancer cases was 67.96 (53.30-79.86) μg/L, significantly higher than that in healthy people and colorectal polyps patients. The differences were statistically significant (all P<0.01). Serum NGAL protein level was significantly associated with tumor diameter, TNM stage, lymph node metastasis and vascular involvement (P<0.05). The optimal cut-off point of serum NGAL protein level for diagnosing colorectal cancer was 49.78 μg/L, and the sensitivity and specificity were 88% and 81% respectively. As for colorectal cancer patients with stage I, the sensitivity of serum NGAL (78.9%) was significantly higher as compared to CA19-9 (31.6%) and CEA (36.8%); as for those with stage II, the sensitivity of serum NGAL(88.0%) was also significantly higher compared to CA19-9 (48.0%) and CEA (52.0%). Kaplan-Meier analysis showed that patients with positive NGAL (≥49.78 μg/L) had worse survival than those with negative NGAL (P=0.002). Multivariate analysis showed that NGAL was an independent prognostic factor (HR=2.060, 95%CI:1.023-4.150, P=0.043).

CONCLUSIONS

NGAL can be served as the novel malignant biological phenotype marker for human colorectal cancer and can be used for the risk stratification. NGAL may be an independent prognostic factor in colorectal cancer.

摘要

目的

探讨检测血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在人类结直肠癌中的可行性及临床意义。

方法

采用夹心酶联免疫吸附测定法分别检测133例健康人、125例结直肠息肉患者和100例结直肠癌患者血清样本中NGAL的水平。分析NGAL水平与结直肠癌患者临床病理特征的关系。通过ROC曲线确定血清NGAL诊断结直肠癌的最佳临界值，并与癌胚抗原（CEA）和糖类抗原19-9（CA19-9）进行比较。进行单因素和多因素分析以检验NGAL水平与结直肠癌患者预后的关系。

结果

100例结直肠癌患者血清NGAL蛋白水平中位数为67.96（53.30 - 79.86）μg/L，显著高于健康人和结直肠息肉患者。差异具有统计学意义（均P<0.01）。血清NGAL蛋白水平与肿瘤直径、TNM分期、淋巴结转移及血管侵犯显著相关（P<0.05）。血清NGAL蛋白水平诊断结直肠癌的最佳临界点为49.78μg/L，灵敏度和特异度分别为88%和81%。对于Ⅰ期结直肠癌患者，血清NGAL的灵敏度（78.9%）显著高于CA19-9（31.6%）和CEA（36.8%）；对于Ⅱ期患者，血清NGAL的灵敏度（88.0%）也显著高于CA19-9（48.0%）和CEA（52.0%）。Kaplan-Meier分析显示，NGAL阳性（≥49.78μg/L）患者的生存率低于NGAL阴性患者（P = 0.002）。多因素分析显示，NGAL是独立的预后因素（风险比=2.060，95%置信区间：1.023 - 4.150，P = 0.043）。