Li Lu-Xi, Zhang Bin, Gong Rui-Zhi
Department of Ophthalmology, Xi'an No 3 Hospital, The Affiliated Hospital of Northwest University.
Department of Hepatobiliary Surgery, Xijing Hospital, The Air Force Medical University.
Medicine (Baltimore). 2020 Mar;99(11):e19382. doi: 10.1097/MD.0000000000019382.
The aim of this study was to evaluate the clinical use of tumor abnormal protein (TAP) in the diagnosis of different cancers.Totally 394 patients were divided into 4 groups, namely 100 healthy volunteers, 167 patients with cancer, 20 subjects with precancerous lesions, and 107 subjects with benign lesions. TAP was detected in 4 groups of research subjects using a TAP testing kit and examination system. We correlated TAP levels with a wide variety of clinical indicators as well as established cancer markers, including alpha fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9). Besides, the changes of TAP level in 51 patients with liver cancer before and after surgery, and overall survival of patients with high or low TAP expression in pancreatic, gallbladder, bile duct, and liver cancers were analyzed.Statistically significant difference was observed in the TAP-positive ratio among subjects with cancer (79.6%) and precancerous lesions (45.0%) compared to the healthy volunteers (4.0%). TAP expression in different cancers was characterized by high sensitivity (79.64%), specificity (89.87%), positive and negative predictive value (85.25% and 85.71%), overall compliance rate (85.53%) but low omission and mistake diagnostic rate (20.36% and 10.13%), Youden index (0.6951). In addition, there was no significant difference among patients with different types of cancer (χ = 2.886, P = .410), and TAP expression was shown to be correlated with AFP in liver cancer (P = .034) but not with CA19-9 in pancreatic cancer (P = .241). Moreover, the overall survival of patients with low expression of TAP in pancreatic, gallbladder, bile duct, and liver cancers were significantly higher than of patients with high expression of TAP. Compared with the preoperative patients with cancer, TAP levels decreased dramatically among postoperative subjects (P < .001).In summary, TAP might hold promise in serving as universal indicator for the diagnosis of different cancers.
本研究旨在评估肿瘤异常蛋白(TAP)在不同癌症诊断中的临床应用。总共394例患者被分为4组,即100名健康志愿者、167例癌症患者、20例癌前病变患者和107例良性病变患者。使用TAP检测试剂盒和检测系统对4组研究对象进行TAP检测。我们将TAP水平与多种临床指标以及既定的癌症标志物(包括甲胎蛋白(AFP)和糖类抗原19-9(CA19-9))进行关联分析。此外,分析了51例肝癌患者手术前后TAP水平的变化,以及胰腺癌、胆囊癌、胆管癌和肝癌中TAP高表达或低表达患者的总生存期。与健康志愿者(4.0%)相比,癌症患者(79.6%)和癌前病变患者(45.0%)的TAP阳性率存在统计学显著差异。TAP在不同癌症中的表达具有高敏感性(79.64%)、特异性(89.87%)、阳性和阴性预测值(85.25%和85.71%)、总体符合率(85.53%),但漏诊和误诊率较低(20.36%和10.13%),约登指数(0.6951)。此外,不同类型癌症患者之间无显著差异(χ = 2.886,P = .410),TAP表达在肝癌中与AFP相关(P = .034),但在胰腺癌中与CA19-9不相关(P = .241)。此外,胰腺癌、胆囊癌、胆管癌和肝癌中TAP低表达患者的总生存期显著高于TAP高表达患者。与术前癌症患者相比,术后患者的TAP水平显著下降(P < .001)。总之,TAP有望成为诊断不同癌症的通用指标。