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探讨血清多标志物模型在结直肠癌筛查中的应用潜力。

Exploration of the application potential of serum multi-biomarker model in colorectal cancer screening.

机构信息

Department of Clinical Laboratory, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China.

Department of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China.

出版信息

Sci Rep. 2024 May 2;14(1):10127. doi: 10.1038/s41598-024-60867-0.

Abstract

Analyzing blood lipid and bile acid profile changes in colorectal cancer (CRC) patients. Evaluating the integrated model's diagnostic significance for CRC. Ninety-one individuals with colorectal cancer (CRC group) and 120 healthy volunteers (HC group) were selected for comparison. Serum levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoproteins (Apo) A1, ApoA2, ApoB, ApoC2, and ApoC3 were measured using immunoturbidimetric and colorimetric methods. Additionally, LC-MS/MS was employed to detect fifteen bile acids in the serum, along with six tumor markers: carcinoembryonic antigen (CEA), carbohydrate antigens (CA) 125, CA19-9, CA242, CA50, and CA72-4. Group comparisons utilized independent sample t-tests and Mann-Whitney U tests. A binary logistic regression algorithm was applied to fit the indicators and establish a screening model; the diagnostic accuracy of individual Indicators and the model was analyzed using receiver operating characteristic (ROC) curves. The CRC group showed significantly lower levels in eight serum lipid indicators and eleven bile acids compared to the HC group (P < 0.05). Conversely, serum levels of TG, CA19-9, and CEA were elevated (P < 0.05). Among the measured parameters, ApoA2 stands out for its strong correlation with the presence of CRC, showcasing exceptional screening efficacy with an area under the curve (AUC) of 0.957, a sensitivity of 85.71%, and a specificity of 93.33%. The screening model, integrating ApoA1, ApoA2, lithocholic acid (LCA), and CEA, attained an impressive AUC of 0.995, surpassing the diagnostic accuracy of individual lipids, bile acids, and tumor markers. CRC patients manifest noteworthy alterations in both blood lipids and bile acid profiles. A screening model incorporating ApoA1, ApoA2, LCA, and CEA provides valuable insights for detecting CRC.

摘要

分析结直肠癌(CRC)患者的血脂和胆汁酸谱变化。评估综合模型对 CRC 的诊断意义。选择 91 例结直肠癌(CRC 组)患者和 120 例健康志愿者(HC 组)进行比较。采用免疫比浊法和比色法检测总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和载脂蛋白(Apo)A1、ApoA2、ApoB、ApoC2 和 ApoC3。此外,还采用 LC-MS/MS 检测血清中的十五种胆汁酸以及六种肿瘤标志物:癌胚抗原(CEA)、糖链抗原(CA)125、CA19-9、CA242、CA50 和 CA72-4。组间比较采用独立样本 t 检验和 Mann-Whitney U 检验。应用二元逻辑回归算法拟合指标,建立筛查模型;采用受试者工作特征(ROC)曲线分析各指标及模型的诊断准确性。CRC 组八项血清脂质指标和十一项胆汁酸水平明显低于 HC 组(P<0.05)。相反,血清 TG、CA19-9 和 CEA 水平升高(P<0.05)。在测定的参数中,ApoA2 与 CRC 的相关性最强,其曲线下面积(AUC)为 0.957,灵敏度为 85.71%,特异性为 93.33%,具有出色的筛查效能。整合 ApoA1、ApoA2、胆酸(LCA)和 CEA 的筛查模型,AUC 达到 0.995,超过了单个脂质、胆汁酸和肿瘤标志物的诊断准确性。CRC 患者的血脂和胆汁酸谱均发生明显改变。纳入 ApoA1、ApoA2、LCA 和 CEA 的筛查模型可为 CRC 的检测提供有价值的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5cf/11066011/469d1ac14c53/41598_2024_60867_Fig1_HTML.jpg

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