医学论文范文:C-12蛋白芯片检测系统在消化道恶性肿瘤诊断中的应用价值
【摘要】 目的 研究多肿瘤标志物蛋白芯片在消化道恶性肿瘤诊断中的应用价值。方法 采用C-12蛋白芯片检测系统检测283例消化道恶性肿瘤患者(恶性肿瘤组)、186例消化道良性疾病患者(良性疾病组)和421例正常对照者(正常对照组)血清中12种肿瘤标志物的表达水平。结果 恶性肿瘤组的阳性率为77.74%,显著高于良性疾病组(35.48%, P<0.01)和正常对照组(22.09%,P<0.01)。该蛋白芯片对消化道恶性肿瘤检测的灵敏度为77.74%,特异度为73.81%,准确率为75.06%,阳性预测值为58.05%,阴性预测值为87.67%;联合检测的阳性率均显著高于单一标志物检测(P<0.05), 但是联合检测对临床Ⅰ、Ⅱ期消化道恶性肿瘤的阳性率仍然偏低,为30.16%;癌胚抗原(CEA)、CA19-9、CA242、CA15-3、CA125、铁蛋白在消化道恶性肿瘤中的表达明显强于其他标志物(P<0.05)。结论 C-12蛋白芯片检测系统监测病情和判断预后的价值优于诊断价值,但是用于消化道恶性肿瘤的早期诊断灵敏度不高。建议利用近年来血清肿瘤标志物研究的最新成果,对现有指标进行优化组合,推出一款专门针对消化道恶性肿瘤的蛋白芯片,以提高其检测效果和早期诊断率。
【关键词】 消化道恶性肿瘤;肿瘤标志物;蛋白芯片;早期诊断
The application value of C-12 protein biochip detective system in the diagnosis
of digestive tract malignancies
XING Fei, WANG Zhuangmei, WANG Yiqiu
(Department of Gastroenterology, The First People′s Hospital of Xuzhou, Xuzhou, Jiangsu 221002, China)
Abstract: Objective To investigate the application value of C-12 protein biochip detective system in the diagnosis of digestive tract malignancies. Methods The expression of twelve tumor markers in serum were detected by protein biochip technology in 283 cases of malignant tumor of digestive tract cancer, 186 cases of benign digestive diseases and 421 cases of normal control. Results The positive ratio of 77.74% in the malignant tumor group was significantly higher than that of the benign diseases group (35.48%, P<0.01) and the normal control group (22.09%, P<0.01). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the protein biochip system were 77.74%, 73.81%, 75.06%, 58.05%, and 87.67%, respectively. The positive ratio of combined detection was significantly higher than that of single tumor maker (P<0.05), but its positive ratio of 30.16% for staging Ⅰ and Ⅱ digestive tract cancer was still relatively low. The expression of tumor markers CEA, CA19-9, CA242, CA15-3, CA125 and ferrtin in digestive tract cancer was markedly stronger than the others (P<0.05). Conclusions The effect of C-12 protein biochip detection system on illness monitoring and prognosis judgment was better than that on diagnosis, but it had less sensitivity for the early diagnosis of digestive tract cancer. It is preferable that the existing indicators be optimized and combined according to the latest achievements of the researches on serum tumor markers in recent years and that a specific, digestive tract cancer-targeted protein biochip be designed so as to improve the detection effectiveness and the accuracy of early diagnosis of malignant tumors of the digestive tract.
Key words: digestive tract malignancies; tumor marker; protein biochip; early diagnosis
消化道恶性肿瘤的早期临床症状没有特异性,发现时多为晚期,甚至发生远处转移,失去手术治疗机会。早期发现、早期诊断和早期治疗是目前提高消化道恶性肿瘤生存率的最有效途径。多肿瘤标志物蛋白芯片检测系统具有高通量检测、高灵敏度、高特异度和微型化的特点,有研究表明,该技术对消化道恶性肿瘤的早期诊断具有一定的作用[1-2]。本研究采用C-12蛋白芯片检测系统对食管癌、胃癌和大肠癌3种最常见的消化道恶性肿瘤患者血清中12种肿瘤标志物进行联合检测,同时选取良性疾病患者和正常人群的检测结果作为对照,分析和比较其表达情况,并结合相关临床资料,以探讨C-12蛋白芯片检测系统在消化道恶性肿瘤诊断中的应用价值医学全.在.线www.lindalemus.com。
1 资料和方法
1.1 一般资料和分组 恶性肿瘤组均为我院2005年6月—2008年12月住院治疗的消化道恶性肿瘤患者,共283例,均经病理检查确诊,其中食管癌72例,胃癌115例,大肠癌96例。临床分期:Ⅰ期26例,Ⅱ期37例,Ⅲ期86例,Ⅳ期134例;男性178例,女性105例,平均年龄57.4岁(24~86岁)。消化道良性疾病组(良性疾病组)186例,为同期住院消化道良性疾病患者,其中反流性食管炎28例,慢性胃炎46例,消化性溃疡62例,溃疡性结肠炎21例,急性胰腺炎11例,急性胆囊炎18例;男性112例,女性74例,平均年龄55.6岁(21~84岁)。正常对照组421例,来源于门诊健康体检者,其中男性268例,女性153例,平均年龄49.2岁(22~81岁)。
1.2 仪器和试剂 全部由浙江湖州数康生物科技有限公司提供,包括HD-2001A生物芯片检测仪、生物芯片图像分析系统软件、C-12蛋白芯片多种肿瘤检测用试剂盒。
1.3 测定方法 采集空腹静脉血2 ml,离心后收集无溶血的血清标本,置于4℃冰箱保存待测,测试前平衡至室温。所有步骤均严格按照C-12蛋白芯片检测系统说明书进行操作。
1.4 正常参考值范围 糖链抗原19-9(CA19-9)<35 kU/L,神经元特异性烯醇化酶(NSE)<13 μg/L,癌胚抗原(CEA)<5 μg/L,糖链抗原242(CA242)<20 kU/L,糖链抗原125(CA125)<35 kU/L,糖链抗原15-3(CA15-3)<35 kU/L,甲胎蛋白(AFP)<20 μg/L,铁蛋白<219 μg/L(女)、322 μg/L(男),游离型前列腺特异性抗原(F-PSA)<1 μg/L,前列腺特异性抗原(PSA)<5 μg/L,人生长激素(HGH)<7.5 μg/L及人绒毛膜促性腺激素β(β-HCG)<3.00 μg/L。
1.5 结果判断标准 检测指标超过临界值即为阳性,在正常参考值范围以内为阴性。
1.6 统计学处理 采用SPSS 13.0统计软件进行统计分析,显著性检验使用χ2检验,P<0.05为差异有统计学意义。
2 结 果
2.1 3组C-12蛋白芯片检测结果比较 恶性肿瘤组的总阳性率显著高于良性疾病组(P< 0.01)和正常对照组(P<0.01)。见表1。本研究中C-12蛋白芯片对消化道恶性肿瘤检测的灵敏度为77.74%,特异度为73.81%,准确率为75.06%,阳性预测值为58.05%,阴性预测值为87.67%。表1 C-12蛋白芯片对各组检测的总阳性率比较与恶性肿瘤组比较: