| 毕晓峰,张 超,李 茉.血清GDF15诊断及筛查结直肠癌的临床价值[J].中国肿瘤,2020,29(12):970-975. |
| 血清GDF15诊断及筛查结直肠癌的临床价值 |
| Serum Growth Differentiation Factor-15 Levels in the Dia-gnosis and Screening of Colorectal Cancer |
| 中文关键词 修订日期：2020-09-17 |
| DOI：10.11735/j.issn.1004-0242.2020.12.A014 |
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| 中文关键词: 生长分化因子15 结直肠癌 早期诊断 筛查 |
| 英文关键词:growth differentiation factor-15 colorectal cancer early diagnosis screening |
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| 中文摘要: |
| 摘 要：［目的］ 通过较大样本回顾性研究生长分化因子15 (GDF-15)在结直肠癌中的诊断价值，并探索GDF15及多肿瘤标志物联合应用辅助诊断早期结直肠癌的临床意义。［方法］ 应用GDF15定量检测试剂及化学发光免疫分析法，分别检测未接受治疗结直肠癌患者（441例）、治疗后四周结直肠癌患者（179例）和正常健康人群（617名）血清样本中GDF15、CA19-9和CEA水平，探索结直肠癌患者血清GDF15水平与临床分期等临床特征的相关关系，以及GDF15与CA19-9、CEA联用筛查早期结直肠癌的可能性。［结果］结直肠癌患者血清GDF15水平显著高于正常人群（P<0.001），且其血清水平随患者临床分期进展而显著上升（P<0.001），与肿瘤浸润程度（P=0.04）、淋巴结转移与否（P=0.017）、是否存在远端转移（P<0.001）及发病部位（直肠vs结肠，P=0.007）均显著相关。血清GDF15作为肿瘤标志物诊断结直肠癌的灵敏度显著高于CA19-9和CEA（52.4% vs 14.5%，36.3%），尤其在诊断早期结直肠癌患者时，其灵敏度差异更为显著（Ⅰ期43.4% vs 5.7%，7.5%；Ⅱ期55.0% vs 12.9%，35.0%）；GDF15与CEA联合应用诊断结直肠癌的灵敏度可达68.3%，其中Ⅰ期结直肠癌灵敏度为49.1%，Ⅱ期结直肠癌灵敏度为70.0%。［结论］ GDF15与结直肠癌的临床进展显著相关，是结直肠癌尤其是早期结直肠癌有价值的血清肿瘤标志物，GDF15和CEA联合检测用于结直肠癌早期筛查具有重要的辅助价值。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the diagnostic value of serum growth differentiation factor-15(GDF15) level in patients with colorectal cancer(CRC). ［Methods］ The serum levels of GDF15，CA19-9 and CEA were analyzed by GDF15 quantitative detection reagent and chemiluminescence immunoassay in 441 untreated CRC patients，179 CRC patients 4 weeks after treatment and 617 healthy subjects，respectively. The association of the serum levels of GDF15 with clinical characters were analyzed. Additionally，the clinical value of combining GDF15 with CA19-9 and CEA was explored in screening of colorectal cancer. ［Results］ The serum levels of GDF15 in patients with CRC were significantly higher than those in healthy control(P<0.001). A stepwise increase of GDF15 levels was noted with the progress of colorectal cancer(P<0.001)，and the levels were significantly correlated with the depth of tumor invasion(P=0.04)，lymph node metastasis(P=0.017)，remote metastasis(P<0.001) and the location of CRC(P=0.007). The sensitivity of GDF15 was superior to CA19-9 and CEA(52.4% vs 14.5%，36.3%). The sensitivities of GDF15 were 43.4% and 55.0% in stage Ⅰ and stage Ⅱ CRC respectively，significantly higher than those of CA19-9(stage Ⅰ，5.7%；stage Ⅱ，12.9%)and CEA(stage Ⅰ，7.5%；stage Ⅱ，35.0%). Furthermore，GDF15 combined with CEA had a sensitivity of 68.3% in the diagnosis of CRC，that was 49.1% for stage Ⅰ CRC and 70.0% for stage Ⅱ CRC.［Conclusion］ GDF15 is significantly related to the clinical stages of CRC. The combination of GDF15 with CEA may be more sensitive in diagnosis and screening of early-stage CRC. |
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