基质金属蛋白酶-1组织抑制剂和癌胚抗原血浆水平对转移性结直肠癌患者化疗反应的预测价值。

Predictive value of tissue inhibitor of metalloproteinases-1 and carcinoembryonic antigen plasma levels in response to chemotherapy in patients with metastatic colorectal cancer.

作者信息

Roayaei Mahnaz, Emami Hamid, Adeli Pouria, Rezaei Abbas, Akbari Mojtaba

机构信息

Department of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Radiation Oncology, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2014 Dec;19(12):1129-33.

PMID:25709652

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4333519/

Abstract

BACKGROUND

Colorectal cancer is one of the most important causes of morbidity and mortality in the world. It has been suggested that tissue inhibitor of metalloproteinase-1 (TIMP-1) plays a particular role in cancer promotion. The objective of the present study was to compare the effect of repeated measurement of carcinoembryonic antigen (CEA) and TIMP-1 plasma levels in a follow-up response to chemotherapy treatment in patients with unresectable metastatic colorectal cancer by surgery.

MATERIALS AND METHODS

All consecutive patients between 18 and 75 years old in both genders with rectal adenocarcinoma who referred to Sayed Al-Shohada Medical Center, during 6 months of study period enrolled in the study. Level of CEA and TIMP-1 were assessed before and after two cycles of chemotherapy. Furthermore, patients underwent computed tomography scan to assess response to chemotherapy. The sensitivity, specificity, and areas under the receiver operating characteristic curves (AUC) calculated for baseline level of CEA and TIMP.

RESULTS

The mean age of the studied patients was 52.7 ± 7.5 years, 12 patients (48%) were male. Response to chemotherapy after two cycles was 80%. In patients who responded to chemotherapy level of TIMP after treatment was significantly decreased compared to before treatment (P < 0.0001). Before and after treatment in patients who responded to chemotherapy the level of TIMP was significantly lower than who did not response to chemotherapy (P < 0.05). The critical values for the prediction response to chemotherapy for CEA was >63 (AUC: 0.54) and for TIMP was ≤8823 (AUC: 0.68).

CONCLUSION

The present study has identified a strong significant association between high plasma TIMP-1 levels and short survival in patients with colorectal cancer. In addition, results demonstrated that the TIMP-1 provides stronger prognostic information than CEA.

摘要

背景

结直肠癌是全球发病和死亡的最重要原因之一。有人提出金属蛋白酶组织抑制剂-1（TIMP-1）在癌症进展中起特殊作用。本研究的目的是比较在不可切除的转移性结直肠癌患者中，重复测量癌胚抗原（CEA）和TIMP-1血浆水平对化疗治疗随访反应的影响。

材料与方法

在研究期间的6个月内，所有年龄在18至75岁之间、患有直肠腺癌的连续患者，无论男女，均转诊至赛义德·阿尔-肖哈达医疗中心并纳入研究。在化疗两个周期前后评估CEA和TIMP-1水平。此外，患者接受计算机断层扫描以评估化疗反应。计算CEA和TIMP基线水平的敏感性、特异性和受试者操作特征曲线下面积（AUC）。

结果

研究患者的平均年龄为52.7±7.5岁，12名患者（48%）为男性。两个周期化疗后的反应率为80%。化疗有反应的患者治疗后TIMP水平较治疗前显著降低（P<0.0001）。化疗有反应的患者治疗前后TIMP水平显著低于无反应的患者（P<0.05）。CEA预测化疗反应的临界值>63（AUC：0.54），TIMP的临界值≤8823（AUC：0.68）。