中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2013年
7期
643-647
,共5页
王慜杰%严翠娥%李学祥%胡书生%韩晓红%齐军
王慜傑%嚴翠娥%李學祥%鬍書生%韓曉紅%齊軍
왕민걸%엄취아%리학상%호서생%한효홍%제군
肝肿瘤%肿瘤标记,生物学%N-乙酰神经氨酸
肝腫瘤%腫瘤標記,生物學%N-乙酰神經氨痠
간종류%종류표기,생물학%N-을선신경안산
Liver neoplasms%Tumor markers,biological%N-acetylneuraminic acid
目的 评价血清唾液酸(SA)在肝癌诊断和疗效监测中的临床价值.方法 用罗氏P800全自动分析仪检测2011年1月至2012年10月中国医学科学院肿瘤医院就诊的221例肝癌(原发性肝癌183例,转移性肝癌38例)、117例肝良性疾病患者和150名健康人血清SA含量；采用高、低两个浓度的样本,每日测量4次,连续测量5d,评价SA试剂盒的批内和批间变异系数(CV)；用183例原发性肝癌和150名健康人血清SA检测数据绘制受试者工作曲线(ROC曲线)确定SA的临界值,并评价SA的诊断价值.同时,对103例肝癌患者治疗前和治疗后1、7、14 d和1、3、6、9个月的SA水平进行追踪监测和评价分析.采用SPSS16.0进行统计分析.结果 低浓度水平样本的批内和日间变异分别为2.4％和3.2％；高水平样本的批内和日间变异分别为2.2％和3.1％.用ROC曲线确定SA的临界值为659 mg/L,用其诊断肝癌的敏感度和特异度分别为63.4％ (116/183)、94.7％(142/150).肝癌患者血清SA水平[(726±173) mg/L]明显高于肝良性疾病组[(552±128) mg/L]和健康对照组[(599±62) mg/L,U值分别为1832.52和887.00,P＜0.01].随访103例原发性肝癌患者,其血清SA水平在治疗后1周升高[(817±193) mg/L,t=-3.272,P＜0.05]；持续到治疗后1个月[(782±173) mg/L,t=-2.694,P＜0.05]；在第3个月时,SA降低至治疗前水平[(662±138) mg/L,t=1.225,P＞0.05]；第6个月时降低至[(615±144) mg/L,t=1.999,P＜0.05],接近健康对照组水平；有85例肝癌患者SA水平与治疗前相比降低,与临床病情的符合率为82.5％(85/103,Kappa值0.79).有5例肝癌患者在治疗后第9个月复发,SA水平明显增高[(939±175)mg/L].结论 血清SA对肝癌的辅助诊断和疗效监测可能有临床价值.
目的 評價血清唾液痠(SA)在肝癌診斷和療效鑑測中的臨床價值.方法 用囉氏P800全自動分析儀檢測2011年1月至2012年10月中國醫學科學院腫瘤醫院就診的221例肝癌(原髮性肝癌183例,轉移性肝癌38例)、117例肝良性疾病患者和150名健康人血清SA含量；採用高、低兩箇濃度的樣本,每日測量4次,連續測量5d,評價SA試劑盒的批內和批間變異繫數(CV)；用183例原髮性肝癌和150名健康人血清SA檢測數據繪製受試者工作麯線(ROC麯線)確定SA的臨界值,併評價SA的診斷價值.同時,對103例肝癌患者治療前和治療後1、7、14 d和1、3、6、9箇月的SA水平進行追蹤鑑測和評價分析.採用SPSS16.0進行統計分析.結果 低濃度水平樣本的批內和日間變異分彆為2.4％和3.2％；高水平樣本的批內和日間變異分彆為2.2％和3.1％.用ROC麯線確定SA的臨界值為659 mg/L,用其診斷肝癌的敏感度和特異度分彆為63.4％ (116/183)、94.7％(142/150).肝癌患者血清SA水平[(726±173) mg/L]明顯高于肝良性疾病組[(552±128) mg/L]和健康對照組[(599±62) mg/L,U值分彆為1832.52和887.00,P＜0.01].隨訪103例原髮性肝癌患者,其血清SA水平在治療後1週升高[(817±193) mg/L,t=-3.272,P＜0.05]；持續到治療後1箇月[(782±173) mg/L,t=-2.694,P＜0.05]；在第3箇月時,SA降低至治療前水平[(662±138) mg/L,t=1.225,P＞0.05]；第6箇月時降低至[(615±144) mg/L,t=1.999,P＜0.05],接近健康對照組水平；有85例肝癌患者SA水平與治療前相比降低,與臨床病情的符閤率為82.5％(85/103,Kappa值0.79).有5例肝癌患者在治療後第9箇月複髮,SA水平明顯增高[(939±175)mg/L].結論 血清SA對肝癌的輔助診斷和療效鑑測可能有臨床價值.
목적 평개혈청타액산(SA)재간암진단화료효감측중적림상개치.방법 용라씨P800전자동분석의검측2011년1월지2012년10월중국의학과학원종류의원취진적221례간암(원발성간암183례,전이성간암38례)、117례간량성질병환자화150명건강인혈청SA함량；채용고、저량개농도적양본,매일측량4차,련속측량5d,평개SA시제합적비내화비간변이계수(CV)；용183례원발성간암화150명건강인혈청SA검측수거회제수시자공작곡선(ROC곡선)학정SA적림계치,병평개SA적진단개치.동시,대103례간암환자치료전화치료후1、7、14 d화1、3、6、9개월적SA수평진행추종감측화평개분석.채용SPSS16.0진행통계분석.결과 저농도수평양본적비내화일간변이분별위2.4％화3.2％；고수평양본적비내화일간변이분별위2.2％화3.1％.용ROC곡선학정SA적림계치위659 mg/L,용기진단간암적민감도화특이도분별위63.4％ (116/183)、94.7％(142/150).간암환자혈청SA수평[(726±173) mg/L]명현고우간량성질병조[(552±128) mg/L]화건강대조조[(599±62) mg/L,U치분별위1832.52화887.00,P＜0.01].수방103례원발성간암환자,기혈청SA수평재치료후1주승고[(817±193) mg/L,t=-3.272,P＜0.05]；지속도치료후1개월[(782±173) mg/L,t=-2.694,P＜0.05]；재제3개월시,SA강저지치료전수평[(662±138) mg/L,t=1.225,P＞0.05]；제6개월시강저지[(615±144) mg/L,t=1.999,P＜0.05],접근건강대조조수평；유85례간암환자SA수평여치료전상비강저,여림상병정적부합솔위82.5％(85/103,Kappa치0.79).유5례간암환자재치료후제9개월복발,SA수평명현증고[(939±175)mg/L].결론 혈청SA대간암적보조진단화료효감측가능유림상개치.
Objective To investigate the clinical significance of the serum sialic acid (SA) detection for the diagnosis and therapy monitoring in liver cancer patients.Methods Patients and healthy people of Chinese academy of medical science cancer hospital from January 2011 to October 2012,were enrolled,including 221 liver cancer patients (183 primary hepatic carcinoma patients and 38 metastatic hepatic carcinoma patients),117 benign liver disease patients and 150 healthy people.The concentration of serum SA were tested by ROCHE P800.The intra-assay and inter-assay coefficient of variation (CV) of SA kit were evaluated by use of low and high concentration samples,measured for 5 days and 4 times each day.Receiver operating characteristic (ROC) curve were used to determine the cut-off of SA using data of 183 cases of primary liver cancer and 150 healthy controls.The area under the curve (ROC-AUC) were used to evaluate the diagnostic value of SA.The changes of serum SA level in 103 cases of primary hepatic carcinoma patients were monitored before therapy and at the 1 st day,7 th day,14 th day,1 st month,3rd month,6 th month and 9 th month after treatment.SPSS16.0 was used to analyse the results.Results The intra and inter-day CVs for low level sample were 2.4％ and 3.2％ respectively,and for high level sample were 2.2％ and 3.1％.The cut-off value of the serum SA was 659 mg/L for liver cancer,the sensitivity and specificity was 63.4％ (1 16/183) and 94.7％ (142/150) respectively.The serum SA level of liver cancer group [(726 ± 173) mg/L] was higher than that of liver benign disease patients group [(552 ± 128) mg/ L] and healthy controls group [(599 ± 62) mg/L,U values were 1832.52 and 887.00,P ＜ 0.01].The serum SA level were tracked in 103 cases of primary hepatic carcinoma patients during therapy period.The serum level of SA elevated to [(817 ± 193) mg/L,t =-3.272,P ＜ 0.05] at I st week after treatment and kept at high level until late in 1st month after treatment [(782 ±173) mg/L,t =-2.694,P＜0.05].In the 3rd month,the SA level decreased to that of pretreatment [(662 ± 138) mg/L,t =1.225,P ＞ 0.05].In the 6th months,the SA level declined to [(615 ± 144) mg/L,t =1.999,P ＜0.05],as well as the level of healthy control group.There were 85 cases of hepatic carcinoma patients with decreased SA level compared with that of pretreatment,and the coincidence rate was 82.5％ (85/103),the Kappa value was 0.79.There were 5 cases of patients with hepatic carcinoma relapse after treatment in 9 th months and the SA levels increased significantly to (939 ± 175) mg/L.Conclusion The serum SA has significant values possibly in the diagnosis and therapy monitoring in liver cancer patients.
