CEACAM6在胆管癌中的诊断价值，组织表达情况及其对预后的影响

发布时间：2018-06-16 23:51

本文选题：胆管癌 + CEACAM6　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:研究肿瘤标志物CEACAM6对胆管癌的诊断价值。检测CEACAM6在胆管癌组织中的蛋白表达水平,并分析其对预后的影响。方法:收集河北医科大学第二医院2009年3月至2014年4月临床资料完整的经手术切除后病理证实的胆管癌患者组织蜡块标本70例(腺癌62例,粘液腺癌3例,乳头状腺癌3例,鳞癌1例,神经内分泌癌1例),15例非肿瘤胆道上皮组织作为对照组。收集河北医科大学第二医院2014年9月至2016年12月临床资料完整的经手术切除后病理证实的胆管癌患者血清标本70例,15例胆管炎患者血清作为对照组。1)首先采用酶联免疫吸附测定(ELISA)法测定70例胆管癌患者和15例胆管炎患者血清CEACAM6水平;根据ROC曲线中敏感性和特异性之和最高点为参考,制定CEACAM6的截断值并计算ROC曲线下面积;根据肿瘤标志物诊断效率评估表评价各个肿瘤标志物对胆管癌诊断效率。2)采用免疫组化技术(S-P)法研究检测CEACAM6在70胆管癌组织和15例非肿瘤胆道上皮组织中的表达情况。并结合患者的年龄、肿瘤大小、有无淋巴结转移、肿瘤组织分化程度、临床分期等临床因素进行综合分析。采用SPSS21统计软件进行分析;率的分析用χ2检验或Fisher精确检验,数据采用x±s表示;术后随访我们采用门诊复查,电话及信访的方式,随访率100%,Kaplan-Meier生存曲线法计算患者生存率并行log-rank检验;P0.05具有统计学意义。结果:酶联免疫吸附测定(ELISA)结果显示在胆管癌病人中,CEACAM6的血清值和阳性率与胆管炎组比较有显著升高(P0.05);根据制定的ROC曲线,CEACAM6在本次实验中血清中含量测定的截断值为0.1851 ng/ml,并分别计算出CEACAM6,CA19-9,CEA的ROC曲线下面积AUC为0.835,0.870,0.828。面积的95%可信区间为0.758-0.912,0.803-0.936,0.749-0.906。胆管癌敏感性CEACAM6CA19-9CEA(P0.05);特异性CA19-9CEACAM6CEA(P0.05)。免疫组化结果显示70例胆管癌、15例非肿瘤胆道上皮组织中CEACAM6阳性表达率分别为87.1%、20%,CEACAM6蛋白在胆管癌中的表达明显高于非肿瘤胆道上皮组织(P0.01)。CEACAM6蛋白表达与胆管癌的临床分期、淋巴结转移和组织学分级明显相关(P0.05)。CEACAM6低表达组生存时间明显长于高表达组(P0.05)。结论:1 CEACAM6在胆管癌血清中高表达,并且阳性率显著高于胆管炎对照组,统计学分析显示有意义。表明CEACAM6的血清学诊断与胆管癌的良恶性存在密切关系,可为胆管癌早期诊断提供思路。2 CEACAM6的ROC曲线分析结果及诊断价值评估表显示:应用酶联免疫吸附测定(ELISA)法,我们得出结论:与CA19-9和CEA比较,CEACAM6具备较高的诊断价值且在敏感性上最高,但特异性较低,总体来说其既具备单独作为一项肿瘤标志物的诊断价值,也可与CA19-9等相关肿瘤诊断指标行联合检测,可为胆管癌早期诊断提供更好的参考意见。3 CEACAM6蛋白在胆管癌组织中高表达,并且阳性率显著高于非癌正常胆管组织,统计学分析显示有意义。因此,CEACAM6在胆管癌组织蛋白表达水平和血清浓度表达水平上的高表达且均具备统计学意义的特点说明CEACAM6可作为胆管癌的早期诊断的肿瘤标志物。4 CEACAM6蛋白在胆管癌组织中的表达情况与患者的年龄、性别,肿瘤大小无相关性,与肿瘤的临床进展程度,淋巴结转移、组织分化程度存在相关性。可成为判断胆管癌恶性生物学行为的相关指标,说明其表达水平与胆管癌的临床进程密切相关。5胆管癌组织中CEACAM6的蛋白表达程度与患者预后存在相关性。CEACAM6可能是反映胆管癌发生发展及预后的重要生物学指标。
[Abstract]:Objective: To study the diagnostic value of tumor marker CEACAM6 for cholangiocarcinoma. To detect the protein expression level of CEACAM6 in cholangiocarcinoma tissue and to analyze its effect on the prognosis. Methods: to collect the tissue wax blocks of the patients with cholangiocarcinoma confirmed by surgical excision in Second Hospital of Hebei Medical University from March 2009 to April 2014. 70 cases (62 cases of adenocarcinoma, 3 cases of mucinous adenocarcinoma, 3 cases of papillary adenocarcinoma, 1 cases of squamous cell carcinoma, 1 cases of neuroendocrine carcinoma) and 15 cases of non tumor biliary epithelial tissue were used as control group. The serum specimens of the patients with cholangiocarcinoma confirmed by surgical removal from September 2014 to December 2016 of the second hospital of Hebei Medical University were 70 and 15 cases were confirmed. Serum CEACAM6 levels of 70 cholangiocarcinoma and 15 cholangitis were measured by enzyme linked immunosorbent assay (ELISA) in 70 cases of cholangiocarcinoma and 15 cases of cholangitis. The truncation value of CEACAM6 and the area under the ROC curve were calculated according to the sensitivity and specificity of the ROC curve, and the diagnosis of the tumor markers was based on the diagnosis of the tumor markers. The efficiency assessment table was used to evaluate the diagnostic efficiency of tumor markers for cholangiocarcinoma (.2). Immunohistochemical technique (S-P) was used to detect the expression of CEACAM6 in 70 bile duct cancer tissues and 15 non tumor biliary epithelial tissues, and the age, tumor size, lymph node metastasis, tumor tissue differentiation, clinical stage and other clinical stages were combined with the patient's age. The bed factors were analyzed synthetically. The analysis was carried out by SPSS21 statistical software; the analysis of rate was tested by x 2 or Fisher, and the data was expressed by X + s. After the follow-up, we used the outpatient review, the telephone and the letters and visits, the follow-up rate of 100%, the survival rate of the patients by the Kaplan-Meier survival curve and the log-rank test; P0.05 has statistics. Results: the results of enzyme linked immunosorbent assay (ELISA) showed that in the patients with cholangiocarcinoma, the serum and positive rates of CEACAM6 were significantly higher than those in the cholangitis group (P0.05). According to the ROC curve, the truncated value of the serum content of CEACAM6 in this experiment was 0.1851 ng/ml, and the ROC curves of CEACAM6, CA19-9 and CEA were calculated respectively. The 95% confidence interval of the area of AUC under the line of 0.835,0.870,0.828. was 0.758-0.912,0.803-0.936,0.749-0.906. cholangiocarcinoma sensitivity CEACAM6CA19-9CEA (P0.05) and specific CA19-9CEACAM6CEA (P0.05). The immunohistochemical results showed that 70 cases of cholangiocarcinoma and 15 cases of non tumor biliary epithelial tissue were 87.1%, 20%, and CEACAM6 eggs, respectively. The expression of white in cholangiocarcinoma was significantly higher than that of non tumor biliary epithelial tissue (P0.01).CEACAM6 protein expression and clinical stage of cholangiocarcinoma. Lymph node metastasis and histological grade were significantly correlated (P0.05).CEACAM6 low expression group was significantly longer than high expression group (P0.05). Conclusion: 1 CEACAM6 in cholangiocarcinoma serum high expression, and positive rate Statistically significant higher than the control group of cholangitis, statistical analysis showed that the serological diagnosis of CEACAM6 was closely related to the benign and malignant cholangiocarcinoma. The results of the ROC curve analysis for the early diagnosis of cholangiocarcinoma and the assessment of the value of the diagnostic value of.2 CEACAM6 showed that the application of enzyme linked immunosorbent assay (ELISA) method, we concluded the conclusion. Compared with CA19-9 and CEA, CEACAM6 has high diagnostic value and is of the highest sensitivity, but its specificity is low. In general, it not only has the diagnostic value of a tumor marker alone, but also can be combined with CA19-9 and other related tumor diagnosis indicators. It can provide a better reference for the early diagnosis of cholangiocarcinoma.3 CEACAM6 eggs. White is highly expressed in cholangiocarcinoma, and the positive rate is significantly higher than that of non cancer normal bile duct tissue. Statistical analysis shows significance. Therefore, the high expression of CEACAM6 in the expression level of cholangiocarcinoma tissue protein and the level of serum concentration is statistically significant and CEACAM6 can be used as an early diagnosis of cholangiocarcinoma. The expression of the tumor marker.4 CEACAM6 protein in the cholangiocarcinoma tissue is not related to the age, sex, and the size of the tumor. It is related to the clinical progress, lymph node metastasis and the degree of tissue differentiation. It can be a relative index to judge the malignant biological behavior of cholangiocarcinoma, indicating the expression level of the cholangiocarcinoma and the clinical of the cholangiocarcinoma. The protein expression of CEACAM6 in.5 cholangiocarcinoma tissue is closely related to the prognosis of patients with.CEACAM6, which may be an important biological indicator to reflect the development and prognosis of cholangiocarcinoma.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.8

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