食管鳞癌患者血清DKK-1的检测及其临床意义

目的 检测食管癌患者血清中DKK-1(dickkopf-1)的表达水平,探讨其在食管癌辅助诊断中的价值.方法 应用酶联免疫吸附法(ELISA)检测80例食管鳞癌患者和35例健康对照组血清中DKK-1的浓度,计算DKK-1诊断食管鳞癌的敏感性、特异性、阳性预测值和阴性预测值,并与细胞角蛋白19片段(CYFRA21-1)和癌胚抗原(CEA)的检测做比较,探讨其在食管癌辅助诊断中的价值.结果 ①食管鳞癌患者血清中DICK-1浓度为90.44±57.41 ng/ml,而正常对照组为11.29±9.45 ng/ml,两者差异有统计学意义(P<0.01).②以正常人血清DKK-1浓度95%可信区间上限(14.54 ng/ml)为界值,则食管鳞癌患者血清中DICK-1的敏感性为66.25%(53/80);正常人血清中的DICK-1阳性率仅为17.14%(6/35),两者差异有统计学意义(P<0.01).③食管鳞癌患者血清中DKK-1的阳性率与肿瘤大小、分化程度无关(P>0.05),而与肿瘤分期和淋巴结转移密切相关(P<0.05).④3种肿瘤标记物检测比较分析显示,在诊断食管癌时,DKK-1的敏感性为66.25%,与CEA(39.44%)和CYFRA21-1(25.35%)间差异有统计学意义(P<0.05).结论 DKK-1在食管癌的发生、生长和转移过程中起着极其重要的作用,有可能成为一种新的肿瘤标记物用于食管癌的辅助诊断.

A study on the measuremet of DKK-1 in the serum of esophageal cancer patients

Objective To explore the expression of DKK-1 and its clinical value in patients with e-sophageal cancer. Methods The levels of serum DKK-1 were measured by sandwich enzyme linked immu-nosorbent assay(ELISA) in 80 patients with esophageal squamous cell cancer and in 35 healthy subjects. The sensitivities of serum DKK-1, CEA and CYFRA21-1 in the patients with esophageal squamous cell cancer were calculated and analyzed to compare their values in diagnosis of esophageal cancer. Results The serum DKK- 1 levels in patients with esophageal squamous cell cancer were significantly higher than those of healthy subjects(P<0.05). According to the highest value of medicine reference of DKK- 1 (14. 54 ng/ml), its sensitivity and specificity were 66. 25% and 82. 86% respectively; There was a significant difference between the sensitivity of DKK-1 in patients with esophageal squamons cell cancer(66. 25%) and that in healthy subjects(17.14%) (P<0.05). The sensitivitis of serum DKK- 1 in patients with esophageal squamous cell cancer were associated with tumor size, TNM stage and lymph node metastasis(P <0.05),but not associated with gender,age and differentiation grade(P>0.05). And the sensitivity of DKK-1 (66. 25%) was significantly higher than that of CEA, CYFRA21-1 (39. 44% ,25. 35%, P <0. 01). Conclusion DKK-1 played a very important role in the growth and metastasis of esophageal cancer and may be a new tumor marker or an important index in the diagno-sis of esophageal cancer.