中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2013年
8期
532-537
,共6页
王钰虹%林原%薛玲%杨秋辰%陈旻湖%陈洁
王鈺虹%林原%薛玲%楊鞦辰%陳旻湖%陳潔
왕옥홍%림원%설령%양추신%진민호%진길
胃肠肿瘤%胰腺肿瘤%神经内分泌瘤%嗜铬粒蛋白类%酶联免疫吸附测定
胃腸腫瘤%胰腺腫瘤%神經內分泌瘤%嗜鉻粒蛋白類%酶聯免疫吸附測定
위장종류%이선종류%신경내분비류%기락립단백류%매련면역흡부측정
Gastrointestinal neoplasms%Pancreatic neoplasms%Neuroendocrine tumors%Chromogranins%Enzyme-linked immunosorbent assay
目的 探讨血清嗜铬素A对胃肠胰神经内分泌肿瘤(GEP-NEN)诊断和疗效评价的价值.方法 纳入2011年1月至2012年12月确诊为GEP-NEN的87例患者,包括50例有病灶者和37例术后无病灶者,同时将84名健康体检者作为健康对照组,采用ELISA法测定所有受试者的血清嗜铬素A水平.统计学方法采用非参数检验、ROC曲线和单因素Cox回归分析.结果 有病灶组患者血清嗜铬素A水平中位数为97 μg/L,高于术后无病灶组的42 μg/L(Z=3.451,P=0.001)和健康对照组的47 μg/L (Z=3.149,P=0.002).以95 μg/L作为健康者或无病灶患者与有病灶患者的诊断临界点,其检测敏感度为54.0％,特异度为90.1％.有远处转移患者血清嗜铬素A水平中位数为231 μg/L,高于无远处转移患者的46 μg/L(Z=3.340,P=0.001).治疗后血清嗜铬素A较基线水平下降≥20％的12例患者,其肿瘤完全缓解、部分缓解或稳定；血清嗜铬素A较基线水平升高≥20％的5例患者,其肿瘤出现进展.单因素Cox回归分析显示,GEP-NEN患者血清嗜铬素A水平与预后无关(r=1.000,P=0.252).结论 神经内分泌肿瘤标志物嗜铬素A对于GEP-NEN有较高的诊断价值,可作为临床诊断GEP-NEN和疗效评价的重要标志物.
目的 探討血清嗜鉻素A對胃腸胰神經內分泌腫瘤(GEP-NEN)診斷和療效評價的價值.方法 納入2011年1月至2012年12月確診為GEP-NEN的87例患者,包括50例有病竈者和37例術後無病竈者,同時將84名健康體檢者作為健康對照組,採用ELISA法測定所有受試者的血清嗜鉻素A水平.統計學方法採用非參數檢驗、ROC麯線和單因素Cox迴歸分析.結果 有病竈組患者血清嗜鉻素A水平中位數為97 μg/L,高于術後無病竈組的42 μg/L(Z=3.451,P=0.001)和健康對照組的47 μg/L (Z=3.149,P=0.002).以95 μg/L作為健康者或無病竈患者與有病竈患者的診斷臨界點,其檢測敏感度為54.0％,特異度為90.1％.有遠處轉移患者血清嗜鉻素A水平中位數為231 μg/L,高于無遠處轉移患者的46 μg/L(Z=3.340,P=0.001).治療後血清嗜鉻素A較基線水平下降≥20％的12例患者,其腫瘤完全緩解、部分緩解或穩定；血清嗜鉻素A較基線水平升高≥20％的5例患者,其腫瘤齣現進展.單因素Cox迴歸分析顯示,GEP-NEN患者血清嗜鉻素A水平與預後無關(r=1.000,P=0.252).結論 神經內分泌腫瘤標誌物嗜鉻素A對于GEP-NEN有較高的診斷價值,可作為臨床診斷GEP-NEN和療效評價的重要標誌物.
목적 탐토혈청기락소A대위장이신경내분비종류(GEP-NEN)진단화료효평개적개치.방법 납입2011년1월지2012년12월학진위GEP-NEN적87례환자,포괄50례유병조자화37례술후무병조자,동시장84명건강체검자작위건강대조조,채용ELISA법측정소유수시자적혈청기락소A수평.통계학방법채용비삼수검험、ROC곡선화단인소Cox회귀분석.결과 유병조조환자혈청기락소A수평중위수위97 μg/L,고우술후무병조조적42 μg/L(Z=3.451,P=0.001)화건강대조조적47 μg/L (Z=3.149,P=0.002).이95 μg/L작위건강자혹무병조환자여유병조환자적진단림계점,기검측민감도위54.0％,특이도위90.1％.유원처전이환자혈청기락소A수평중위수위231 μg/L,고우무원처전이환자적46 μg/L(Z=3.340,P=0.001).치료후혈청기락소A교기선수평하강≥20％적12례환자,기종류완전완해、부분완해혹은정；혈청기락소A교기선수평승고≥20％적5례환자,기종류출현진전.단인소Cox회귀분석현시,GEP-NEN환자혈청기락소A수평여예후무관(r=1.000,P=0.252).결론 신경내분비종류표지물기락소A대우GEP-NEN유교고적진단개치,가작위림상진단GEP-NEN화료효평개적중요표지물.
Objective To explore the value of serum chromogranin A (CgA) in clinical diagnosis and efficacy evaluation of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).Methods From January 2011 to December 2012,87 GEP-NEN patients were enrolled,which included 50 patients with lesions and 37 patients without lesions after surgery.Eighty-four healthy subjects were taken as control group.The serum CgA levels of all subjects were measured with enzyme linked immunosorbent assay.Nonparametric test,receiver operating characteristic curve and Cox regression univariate analysis were performed for analysis.Results The median of serum CgA level of GEP-NEN patients with lesions was 97μg/L,which was significantly higher than that of patients without lesions after surgery (42 μg/L,Z=3.451,P=0.001) and healthy control (47 μg/L,Z=3.149,P=0.002).The value of 95 μg/L was taken as diagnostic cut-off value for healthy controls,patients without lesions and patients with lesions,the sensitivity and specificity were 54.0％ and 90.1％,respectively.The median of serum CgA level of the patients with distant metastasis was 231 μg/L,which was higher than that of patients without distant metastasis (46 μg/L,Z=3.340,P=0.001).After treatment,the serum CgA levels of 12 patients with complete remission,partial remission or stable tumor decreased more than 20％ of baseline values.The serum CgA levels of five patients increased more than 20 ％ of baseline values and the tumors of them showed progress.Cox regression analysis showed that there was no correlation between CgA levels of patients with lesions and prognosis (r=1.000,P=0.252).Conclusion Neuroendocrine marker CgA has high diagnostic value in GEP-NEN,and can be used as an important biomarker in clinical diagnosis and efficacy evaluation of GEP-NEN.
