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目的探讨胃癌患者可溶性细胞毒T淋巴细胞相关抗原-4(soluble cytotoxic T lymphocyte associated antigen-4,sCTLA-4)表达情况及其对胃癌的诊断价值。方法胃癌患者63例(胃癌组)、慢性萎缩性胃炎患者15例(胃炎组)、胃溃疡患者12例(胃溃疡组)、体检健康者24例(对照组),采用ELISA法检测4组血清sCTLA-4水平,电化学发光法检测癌胚抗原(carcino-embryonic antigen,CEA)和糖类抗原72-4(carbohydrate antigen 72-4,CA72-4)水平,ROC曲线评价sCTLA-4单独及与CEA,CA72-4联合检测在胃癌诊断中的应用价值。结果胃癌组血清sCTLA-4,CEA及CA72-4水平明显高于胃炎组、胃溃疡组及对照组(P<0.05),胃炎组与胃溃疡组血清sCTLA-4水平明显高于对照组(P<0.05),胃炎组与胃溃疡组血清sCTLA-4水平比较差异无统计学意义(P>0.05),胃炎组、胃溃疡组与对照组血清CEA及CA72-4水平比较差异均无统计学意义(P>0.05);胃癌组血清sCTLA-4水平在临床分期与淋巴结转移上差异有统计学意义(P<0.05);sCTLA-4诊断胃癌的AUC为0.618,临界值为8.31ng/mL,灵敏度和特异度分别为72.4%,79.3%,与CEA及CA72-4联合检测诊断胃癌的AUC为0.835,灵敏度和特异度分别为88.9%,94.2%。结论胃癌患者sCTLA-4表达明显升高,其对胃癌早期诊断有重要价值。
Objective To investigate the expression of soluble cytotoxic T lymphocyte associated antigen-4 (sCTLA-4) and its diagnostic value in gastric cancer. Methods Sixty-three gastric cancer patients (gastric cancer group), 15 patients with chronic atrophic gastritis (gastritis group), 12 patients with gastric ulcer (gastric ulcer group) and 24 healthy controls (control group) were enrolled in this study. Serum sCTLA-4 levels and carcinoembryonic antigen (CEA) and carbohydrate antigen 72-4 (CA72-4) levels were detected by electrochemiluminescence. Diagnostic Value of CEA and CA72-4 in Gastric Cancer. Results The levels of sCTLA-4, CEA and CA72-4 in gastric cancer group were significantly higher than those in gastritis group, gastric ulcer group and control group (P <0.05). The levels of sCTLA-4 in gastric cancer group and gastric ulcer group were significantly higher than those in control group <0.05). There was no significant difference in serum sCTLA-4 levels between gastritis group and gastric ulcer group (P> 0.05). There was no significant difference in serum CEA and CA72-4 between gastritis group, gastric ulcer group and control group (P> 0.05). The level of sCTLA-4 in gastric cancer group was significantly different between clinical stage and lymph node metastasis (P <0.05). The AUC of sCTLA-4 in diagnosing gastric cancer was 0.618, the critical value was 8.31ng / mL, And specificity of 72.4% and 79.3% respectively. The AUC of combined detection of CEA and CA72-4 for gastric cancer was 0.835, the sensitivity and specificity were 88.9% and 94.2% respectively. Conclusion The expression of sCTLA-4 in patients with gastric cancer is significantly increased, which is of great value in the early diagnosis of gastric cancer.