N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Moscow, Russia.
A. M. Nikiforov All-Russian Center of Emergency and Radiation Medicine, Ministry of the Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters, St. Petersburg, Russia.
Bull Exp Biol Med. 2022 Jul;173(3):376-379. doi: 10.1007/s10517-022-05552-w. Epub 2022 Jul 19.
Zonulin content in blood serum of patients with colorectal cancer (CRC; n=152; 30-84 years) and patients with large bowel adenomas (n=32; 39-82 years) was measured by standardized kit IDK Zonulin ELISA (Immundiagnostik AG). The healthy control group (n=50) comprised volunteers (27 women, 23 men; 25-68 years); pathological control group (n=84) - patients (55 women, 29 men;18-84 years) with irritable bowel syndrome (n=29), Crohn's disease (n=5), and ulcero-necrotic colitis (n=50). In comparison to healthy control group, the level of zonulin was significantly increased in CRC patients (p<0.0000001) and in patients with benign large bowel tumors (p<0.004), as well as in patients with inflammatory intestine diseases and with irritable bowel syndrome (p<0.0002). Zonulin level in blood serum of CRC patients was slightly, but significantly higher (p<0.05) than in the group of pathological control. ROC curve construction revealed that at optimal zonulin cut-off level (52.2 ng/ml), the diagnostic sensitivity of CRC detection was 66.7% and specificity relative to healthy control was 81.8%. The specificity relative to the combined control group (healthy control+non-tumor bowel diseases) was only 68.9%. Thus, no acceptable cut-off levels for differentiation between malignant and benign tumors, as well as between tumor and non-tumor large bowel pathologies were found. Analysis of the associations between serum zonulin level and the main clinical and pathological characteristics of CRC demonstrated that the level of this marker increased with disease progression (p<0.01; Kruskal-Wallis test), but was not associated with individual criteria of the TNM system, tumor localization, histological structure, and malignancy grade.
血清中紧密连接蛋白（zonulin）含量在结直肠癌（CRC）患者（n=152；30-84 岁）和大肠腺瘤患者（n=32；39-82 岁）中通过标准化试剂盒 IDK Zonulin ELISA（Immundiagnostik AG）进行测量。健康对照组（n=50）由志愿者组成（27 名女性，23 名男性；25-68 岁）；病理对照组（n=84）包括患有肠易激综合征（n=29）、克罗恩病（n=5）和溃疡性坏死性结肠炎（n=50）的患者（55 名女性，29 名男性；18-84 岁）。与健康对照组相比，CRC 患者（p<0.0000001）和良性大肠肿瘤患者（p<0.004）以及炎症性肠病和肠易激综合征患者（p<0.0002）的 zonulin 水平显著升高。CRC 患者血清 zonulin 水平略高于病理对照组（p<0.05），但差异无统计学意义。ROC 曲线构建显示，在最佳 zonulin 截断值（52.2 ng/ml）下，CRC 检测的诊断敏感性为 66.7%，相对于健康对照组的特异性为 81.8%。相对于联合对照组（健康对照组+非肿瘤性肠病）的特异性仅为 68.9%。因此，未发现区分恶性和良性肿瘤以及肿瘤和非肿瘤性大肠病变的可接受截断值。血清 zonulin 水平与 CRC 主要临床和病理特征之间的相关性分析表明，该标志物水平随疾病进展而升高（p<0.01；Kruskal-Wallis 检验），但与 TNM 系统的个别标准、肿瘤定位、组织学结构和恶性程度无关。
