国际肿瘤学杂志

国际肿瘤学杂志 ›› 2022, Vol. 49 ›› Issue (12): 724-728.doi: 10.3760/cma.j.cn371439-20220609-00142

• 论著 • 上一篇    下一篇

胃癌患者血清胰岛素样生长因子结合蛋白7的水平及其诊断价值

柳灿烔1,2, 黄欣仪3, 陈柳伊1, 陈浩4, 彭裕辉1,2, 黄旭纯1()   

  1. 1汕头大学医学院附属肿瘤医院检验科，汕头 505141
    2广东省食管癌研究所，汕头 515041
    3汕头大学医学院第一附属医院消化内镜室，汕头 505141
    4中山大学肿瘤防治中心检验科，广州 510060
  • 收稿日期:2022-06-09 修回日期:2022-06-27 出版日期:2022-12-08 发布日期:2023-01-05
  • 通讯作者: 黄旭纯 E-mail:313623874@qq.com
  • 基金资助:
    国家自然科学基金(81972801);汕头市科技计划(190413105262902)

Level and diagnostic value of serum insulin-like growth factor binding protein 7 in patients with gastric cancer

Liu Cantong1,2, Huang Xinyi3, Chen Liuyi1, Chen Hao4, Peng Yuhui1,2, Huang Xuchun1()   

  1. 1Department of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, Shantou 505141, China
    2Guangdong Esophageal Cancer Research Institute, Shantou 515041, China
    3Department of Gastrointestinal Endoscopy, First Affiliated Hospital, Shantou University Medical College, Shantou 505141, China
    4Department of Clinical Laboratory Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
  • Received:2022-06-09 Revised:2022-06-27 Online:2022-12-08 Published:2023-01-05
  • Contact: Huang Xuchun E-mail:313623874@qq.com
  • Supported by:
    National Natural Science Foundation of China(81972801);Science and Technology Planning Project of Shantou City of China(190413105262902)

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摘要：

目的 探讨胃癌患者血清胰岛素样生长因子结合蛋白7（IGFBP7）的水平及其在胃癌诊断中的意义。方法 选取2019年5月至12月在中山大学肿瘤防治中心住院的100例胃癌患者（胃癌组）作为研究对象，其中早期胃癌患者49例（早期胃癌组），将同时期的94位体检者作为正常对照组。采用酶联免疫吸附试验检测血清IGFBP7的水平，同时收集实验室癌胚抗原（CEA）检测结果，分析血清IGFBP7的水平与胃癌患者临床病理特征的关系，用受试者工作特征（ROC）曲线评估诊断效能。结果 胃癌组患者血清IGFBP7水平为（1.595±0.159）ng/ml，正常对照组为（1.850±0.328）ng/ml，差异具有统计学意义（t=-0.26，P<0.001）；其中早期胃癌组患者血清IGFBP7水平为（1.601±0.153）ng/ml，与正常对照组相比，差异有统计学意义（t=-0.26，P<0.001）。胃癌组患者血清CEA水平为2.230（2.043）ng/ml，正常对照组为1.805（1.020）ng/ml，差异具有统计学意义（U=0.45，P=0.004）；其中早期胃癌组患者血清CEA水平为2.220（1.780）ng/ml，与正常对照组相比，差异有统计学意义（U=0.53，P=0.002）。IGFBP7与胃癌患者的CEA水平（χ2=0.36，P=0.547）、年龄（χ2=0.16，P=0.688）、性别（χ2=0.97，P=0.326）、浸润深度（χ2=0.30，P=0.585）、淋巴结转移（χ2=0.17，P=0.684）、远处转移（χ2=0.09，P=0.767）及TNM分期（χ2=0.38，P=0.537）均无关。ROC曲线分析显示IGFBP7诊断胃癌的曲线下面积（AUC）为0.84，95%CI为0.78~0.89；CEA诊断胃癌的AUC为0.62，95%CI为0.54~0.70，差异有统计学意义（Z=4.33，P<0.001）；联合IGFBP7和CEA诊断胃癌的AUC为0.85，95%CI为0.79~0.90，与单纯使用CEA相比，差异具有统计学意义（Z=4.97，P<0.001）；与单纯使用IGFBP7相比，差异无统计学意义（Z=1.41，P=0.159）。IGFBP7诊断早期胃癌的AUC为0.84，95%CI为0.78~0.91；CEA诊断早期胃癌的AUC为0.66，95%CI为0.56~0.75，差异有统计学意义（Z=3.11，P=0.002）；联合IGFBP7和CEA诊断早期胃癌的AUC为0.85，95%CI为0.78~0.91，与单纯使用CEA相比，差异具有统计学意义（Z=3.54，P<0.001）；与单纯使用IGFBP7相比，差异无统计学意义（Z=1.19，P=0.232）。结论 胃癌患者血清IGFBP7水平较正常人群低，与CEA相比，血清IGFBP7对胃癌诊断价值更优。

关键词: 胃肿瘤, 癌症早期检测, 胰岛素样生长因子结合蛋白7

Abstract:

Objective To investigate the serum level of insulin-like growth factor binding protein 7 （IGFBP7） in patients with gastric cancer and its diagnostic significance. Methods A total of 100 gastric cancer patients （gastric cancer group） including 49 patients with early gastric cancer （early gastric cancer group）, who were hospitalized in Sun Yat-sen University Cancer Center from May to December 2019 were selected as the research subjects, and 94 physical examination subjects during the same period were selected as the normal control group. The levels of serum IGFBP7 were detected by enzyme-linked immunosorbent assay. At the same time, the laboratory carcinoembryonic antigen （CEA） test results were collected. The relationships between the level of serum IGFBP7 and the clinicopathological features of gastric cancer patients were analyzed. The diagnostic value was evaluated by receiver operating characteristic （ROC） curve. Results The level of serum IGFBP7 in the gastric cancer group was （1.595±0.159） ng/ml, and that in the normal control group was （1.850±0.328） ng/ml, with a statistically significant difference （t=-0.26, P<0.001）, and among them, the level of serum IGFBP7 in the early gastric cancer group was （1.601±0.153） ng/ml, and there was a statistically significant difference compared with the normal control group （t=-0.26, P<0.001）. The level of serum CEA in the gastric cancer group was 2.230 （2.043） ng/ml, and that in the normal control group was 1.805 （1.020） ng/ml, with a statistically significant difference （U=0.45, P=0.004）, and among them, the level of serum CEA in the early gastric cancer group was 2.220 （1.780） ng/ml, and there was a statistically significant difference compared with the normal control group （U=0.53, P=0.002）. There were no significant correlations between IGFBP7 and CEA level （χ2=0.36, P=0.547）, age （χ2=0.16, P=0.688）, gender （χ2=0.97, P=0.326）, depth of invasion （χ2=0.30, P=0.585）, lymph node metastasis （χ2=0.17, P=0.684）, distant metastasis （χ2=0.09, P=0.767） and TNM stage （χ2=0.38, P=0.537）. ROC curve analysis showed that the area under the curve （AUC） of IGFBP7 for gastric cancer diagnosis was 0.84 （95%CI: 0.78-0.89）, the AUC of CEA for gastric cancer diagnosis was 0.62 （95%CI: 0.54-0.70）, and there was a statistically significant difference （Z=4.33, P<0.001）. The AUC of IGFBP7 combined with CEA for gastric cancer diagnosis was 0.85 （95%CI: 0.79-0.90）. Compared with CEA alone, there was a statistically significant difference （Z=4.97, P<0.001）. Compared with IGFBP7 alone, there was no statistically significant difference （Z=1.41, P=0.159）. The AUC of IGFBP7 in the diagnosis of early gastric cancer was 0.84 （95%CI: 0.78-0.91）, the AUC of CEA in the diagnosis of early gastric cancer was 0.66 （95%CI: 0.56-0.75）, and there was a statistically significant difference （Z=3.11, P=0.002）. The AUC of IGFBP7 combined with CEA in the diagnosis of early gastric cancer was 0.85 （95%CI: 0.78-0.91）. Compared with CEA alone, there was a statistically significant difference （Z=3.54, P<0.001）. Compared with IGFBP7 alone, there was no statistically significant difference （Z=1.19, P=0.232）. Conclusion The serum IGFBP7 level of gastric cancer patients is lower than that of normal controls. Compared with CEA, serum IGFBP7 has better diagnostic value for gastric cancer.

Key words: Stomach neoplasms, Early detection of cancer, Insulin-like growth factor binding protein 7