大肠癌患者血清中巨噬细胞抑制因子-1升高的临床价值研究

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目的探讨巨噬细胞抑制因子1(MIC-1)在大肠癌诊断和早期诊断、治疗监测及复发预警中的临床价值。方法应用自主研制的MIC-1检测试剂盒检测239例不同临床分期的大肠癌患者、16例肠道良性疾病患者及200例健康人血清样本中MIC-1水平,并对部分肿瘤患者进行连续监测;应用罗氏Cobas 601电化学发光免疫分析仪检测上述样品中的CEA和CA19-9水平并与MIC-1检测结果进行比较。结果大肠癌患者组MIC-1血清水平显著高于良性疾病组和正常对照(分别为1138.16±857.46、486.76±220.93、391.56±299.55,P<0.001);不同临床分期大肠癌患者血清中MIC-1水平呈递增趋势;MIC-1在早期大肠癌患者(Ⅰ期和Ⅱ期)中显示出良好的诊断敏感性,远优于CEA(Ⅰ期:28.0%vs8.0%;Ⅱ期:42.7%vs34.7%),提示MIC-1的早期诊断价值优于CEA;MIC-1与CEA联合检测,可由原来CEA42.3%的灵敏度提高至64.4%,显著优于MIC-1、CEA和CA19-9单独检测;MIC-1血清水平在有效治疗后显著下降(P<0.001),复发转移时MIC-1水平显著升高(P<0.001)。结论研究结果明确显示MIC-1是大肠癌有价值的新血清肿瘤生物标志物,对于提高大肠癌的诊断和早期诊断水平以及反映临床疗效具有重要的临床意义和价值。 Objective To investigate the clinical value of macrophage inhibitory factor-1 (MIC-1) in the diagnosis and early diagnosis, treatment monitoring and early warning of colorectal cancer. Methods The MIC-1 levels of 239 patients with colorectal cancer of different clinical stages, 16 patients with benign intestinal diseases and 200 healthy subjects were detected by the MIC-1 test kit independently developed, and some patients with cancer were continuously monitored The Roche Cobas 601 electrochemiluminescence immunoassay was used to detect the levels of CEA and CA19-9 in the above samples and compared with the results of MIC-1. Results The serum levels of MIC-1 in patients with colorectal cancer were significantly higher than those in benign diseases and controls (1138.16 ± 857.46, 486.76 ± 220.93, 391.56 ± 299.55, respectively; P <0.001) MIC-1 showed a good diagnostic sensitivity in patients with early-stage colorectal cancer (stage Ⅰ and Ⅱ), which was much better than that of CEA (stage Ⅰ: 28.0% vs 8.0%; stage Ⅱ: 42.7% vs 34 .7%), suggesting that the early diagnosis value of MIC-1 is better than that of CEA; MIC-1 and CEA combined detection can be increased from 42.3% of the original CEA sensitivity to 64.4%, significantly better than the MIC-1, CEA and CA19-9 MIC-1 serum levels decreased significantly after effective treatment (P <0.001), and MIC-1 levels were significantly higher in recurrence and metastasis (P <0.001). Conclusions The results of the study clearly show that MIC-1 is a valuable biomarker of new serum tumor in colorectal cancer and has important clinical significance and value for improving the diagnosis and early diagnosis of colorectal cancer and reflecting clinical efficacy.
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