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目的评价血清可溶性CD2(6sCD26)对结直肠癌的诊断价值。方法收集我院59例结直肠癌患者、51例结直肠良性疾病患者和41例健康对照患者的血清,采用ELISA法检测血清中sCD26浓度。采用受试者工作曲线(ROC)法评价血清sCD26对结直肠癌的诊断价值,并采用logistic回归分析其对结直肠癌的关系是否独立于癌胚抗原(CEA)。结果结直肠癌患者血清sCD26水平较健康对照组和结直肠良性疾病组患者增高(P<0.01),但sCD26在Dukes不同分期间的差异无统计学意义(P=0.78)。sCD26诊断结直肠癌的曲线下面积为0.72〔95%可信区间(CI)为0.63～0.82,P<0.01〕,最佳诊断界值为526μg/L。sCD26的诊断敏感度和特异度分别为0.59(95%CI为0.48～0.72)和0.80(95%CI为0.67～0.90)。在包含了CEA的logistic回归模型中,sCD26阳性(≥526μg/L)的优势比为5.17(95%CI为1.72～15.53,P<0.01)。DukesA期结直肠癌患者sCD26较CEA具有更高的阳性率(P=0.03),但Dukes B、C和D期结直肠癌患者sCD26的阳性率均低于CEA(P<0.05)。结论sCD26对结直肠癌具有较高且独立于CEA的诊断价值。与CEA相比,sCD26更具有成为结直肠癌早期标志物的潜质。
Objective To evaluate the diagnostic value of serum soluble CD2 (6sCD26) in colorectal cancer. Methods Serum levels of 59 patients with colorectal cancer, 51 patients with benign colorectal disease and 41 healthy controls were collected. Serum sCD26 concentrations were detected by ELISA. The receiver operating curve (ROC) method was used to evaluate the diagnostic value of serum sCD26 in colorectal cancer. Logistic regression was used to analyze whether its relationship with colorectal cancer was independent of carcinoembryonic antigen (CEA). Results The serum sCD26 levels in patients with colorectal cancer were significantly higher than those in healthy controls and patients with benign colorectal diseases (P <0.01). However, there was no significant difference in sCD26 between different Dukes stages (P = 0.78). The area under the curve for sCD26 diagnosis of colorectal cancer was 0.72 (95% confidence interval (CI) 0.63 to 0.82, P <0.01). The optimal diagnostic cutoff value was 526 μg / L. The diagnostic sensitivity and specificity of sCD26 were 0.59 (95% CI 0.48 to 0.72) and 0.80 (95% CI 0.67 to 0.90), respectively. In logistic regression models that included CEA, odds ratios for sCD26 positive (> 526 μg / L) were 5.17 (95% CI, 1.72 to 15.53, P <0.01). However, the positive rates of sCD26 in Dukes B, C and D colorectal cancer were lower than those in CEA (P <0.05). Conclusion sCD26 has high diagnostic value for colorectal cancer and is independent of CEA. Compared with CEA, sCD26 has the potential to become an early marker of colorectal cancer.