Fan P, Zhang Y, Deng F, Chen S H, Li M, Zhang Q
Department of Abdominal Surgery, The West of Anhui Provincial Hospital (Anhui Provincial Cancer Hospital), Hefei 230031 , China.
Zhonghua Yi Xue Za Zhi. 2017 Sep 12;97(34):2670-2673. doi: 10.3760/cma.j.issn.0376-2491.2017.34.006.
The aim of this paper is to investigate the application value of serum human tumor protein P53 (TP53) in the diagnosis and postoperative monitoring of colorectal cancer. One hundred and fifteen patients with colorectal cancer diagnosed without colorectal cancer and without surgery, radiotherapy and chemotherapy and total of 158 patients with colorectal benign disease and 182 healthy subjects were enrolled in this study. The levels of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) were detected by electrochemiluminescence assay. The expression of TP53 was analyzed by ELISA. Fourth-one patients with colorectal cancer were detected with one day before operation and the first seven days after operation. The expression of CEA, CA199 and TP53 was analyzed by ROC curve. The results were compared with those of CEA and CA199 diagnostic value. The medians of the levels of TP53 in patients with colorectal cancer patients, colorectal benign, and healthy subjects are 316.0(24.6, 940.8 ) , 9.8(3.7, 30.1 ) and 1.9(1.4, 2.5 ) μg/L (=260.161, <0.01), respectively. The level of TP53 in patients with colorectal cancer was significantly higher than that in colorectal benign and healthy subjects. The levels of serum TP53 in patients with colorectal cancer show great discrepancies in different TNM stages, different tumor location, depth of invasion and lymph node metastasis (<0.05) , but no difference in sex, age, and tumor growth type. The levels of TP53 in the same patient is 711.5(354.9, 1 068.0) μg/L in the first seven days after operation, significantly decreased when compared to it in the one day before the operation with the value of 952.6 (419.7, 1485.4) μg/L (=-1.989, <0.05). The difference was statistically significant, and CEA, CA199 were not statistically significant. And the sensitivity (79.1%) and specificity (81.8%) of TP 53 were significantly higher than those of CEA (39.1%, 70.3%) and CA199 (47.8%, 69.1%). If TP53 was combined with CEA and CA199, sensitivity (86.1%) and specificity (87.9%) can be significantly improved, in which the area of Receiver Operating Characteristic (ROC) curve was 0.924. Serum TP53 has a certain positive significance for the diagnosis, postoperative monitoring of colorectal cancer. Combined detection with CEA and CA199 can improve the sensitivity and specificity, implicating good clinical application value.
本文旨在探讨血清人肿瘤蛋白P53(TP53)在结直肠癌诊断及术后监测中的应用价值。本研究纳入了115例未经手术、放疗及化疗确诊的结直肠癌患者,158例结直肠良性疾病患者以及182例健康受试者。采用电化学发光法检测血清癌胚抗原(CEA)和糖类抗原199(CA199)水平,采用酶联免疫吸附测定法分析TP53的表达。对41例结直肠癌患者在术前1天及术后前7天进行检测,通过ROC曲线分析CEA、CA199和TP53的表达,并与CEA和CA199的诊断价值结果进行比较。结直肠癌患者、结直肠良性疾病患者及健康受试者的TP53水平中位数分别为316.0(24.6,940.8)μg/L、9.8(3.7,30.1)μg/L和1.9(1.4,2.5)μg/L(χ² = 260.161,P < 0.01)。结直肠癌患者的TP53水平显著高于结直肠良性疾病患者及健康受试者。结直肠癌患者血清TP53水平在不同TNM分期、不同肿瘤部位、浸润深度及淋巴结转移情况中存在显著差异(P < 0.05),但在性别、年龄及肿瘤生长类型方面无差异。同一患者术后前7天的TP53水平为711.5(354.9,1068.0)μg/L,与术前1天的952.6(419.7,1485.4)μg/L相比显著降低(t = -1.989,P < 0.05),差异具有统计学意义,而CEA、CA199无统计学意义。TP53的敏感性(79.1%)和特异性(81.8%)显著高于CEA(39.1%,70.3%)和CA199(47.8%,69.1%)。若将TP53与CEA和CA199联合检测,敏感性(86.1%)和特异性(87.9%)可显著提高,其中受试者工作特征(ROC)曲线面积为0.924。血清TP53对结直肠癌的诊断及术后监测具有一定的阳性意义,与CEA和CA199联合检测可提高敏感性和特异性,具有良好的临床应用价值。