目的 探讨血浆丝氨酸蛋白酶抑制剂Kazal-type 4(SPINK4)表达在结直肠腺癌(CRC)和进展期腺瘤(AA)中的临床诊断价值.方法 选取2020年6月至2021年12月该院收治并经结肠镜及病理检查确诊的62例CRC患者(CRC组)和15例AA患者(AA组),同期进行体检的22例健康者作为HC组.ELISA检测血浆SPINK4表达,电化学发光法检测血浆CEA表达,并进行相关性分析;受试者工作特征(ROC)曲线分析诊断效能,免疫组织化学检测CRC患者组织中p53表达情况.结果 CRC组及AA组血浆SPINK4表达均低于 HC 组(Z=3.72、0.41,P<0.05),CRC 组 CEA 表达高于 HC 组(Z=-3.63,P<0.05).SPINK4 联合CEA诊断CRC和AA的曲线下面积(AUC)、准确度、灵敏度及特异度均高于SPINK4、CEA单独诊断.CRC患者中SPINK4低表达组及CEA高表达组突变型p53阳性表达率明显增加(72.55%、75.00%,P<0.05).结论 血浆SPINK4在CRC和AA中表达降低,与CEA联合检测对CRC及AA有较好的诊断效能.
Diagnostic value of plasma SPINK4 expression in colorectal adenocarcinoma and progressive adenoma
Objective To investigate the clinical diagnostic value of plasma serine protease inhibitor Ka-zal-type 4(SPINK4)expression in colorectal adenocarcinoma(CRC)and progressive adenoma(AA).Methods A total of 62 patients with CRC(CRC group)and 15 patients with AA(AA group)diagnosed by colonoscopy and pathological examination in this hospital from June 2020 to December 2021 were selected,and 22 healthy people undergoing physical examination during the same period were selected as the HC group.The expression of SPINK4 in plasma was detected by ELISA,and the expression of CEA in plasma was detected by electrochemiluminescence,and the correlation was analyzed.The diagnostic efficiency was analyzed by re-ceiver operating characteristic(ROC)curve,and the expression of p53 in CRC tissues was detected by immu-nohistochemistry.Results The expression of plasma SPINK4 in the CRC group and AA group was lower than that in the HC group(Z=3.72,-0.41,P<0.05),and the expression of CEA in the CRC group was higher than that in the HC group(Z=-3.63,P<0.05).The area under the curve(AUC),accuracy,sensi-tivity and specificity of SPINK4 combined with CEA in the diagnosis of CRC and AA were higher than those of SPINK4 and CEA alone.The positive rate of mutant type p53 in SPINK4 low expression group and CEA high ex-pression group was significantly increased in CRC patients(72.55%,75.00%,P<0.05).Conclusion The expression of plasma SPINK4 is decreased in CRC and AA,and the combined detection of SPINK4 and CEA has a good di-agnostic efficiency in CRC and AA.