肾癌患者血清Cripto-1、Kim-1水平的变化及其临床意义-东南大学学报医学版

肾癌患者血清Cripto-1、Kim-1水平的变化及其临床意义

单位：1. 深圳市龙华区人民医院社康科, 广东深圳 518000;
2. 深圳市人民医院龙华分院泌尿外科, 广东深圳 518000

分类号：R737.11

出版年·卷·期（页码）：2021·40·第一期（78-82）

摘要：

目的：探讨血清畸胎瘤衍生生长因子-1（Cripto-1）、肾损伤分子-1（Kim-1）在肾癌患者中的水平及其临床意义。方法：选取2017年1月至2019年1月接受治疗的108例肾癌患者作为研究对象（实验组），另选同期60例体检健康志愿者（对照组）。采用酶联免疫吸附法检测两组血清Cripto-1、Kim-1水平。分析不同肿瘤直径、肿瘤分期、Fuhrman分级、有无淋巴结及远处转移肾癌患者的血清Cripto-1、Kim-1水平差异。绘制受试者工作特征（ROC）曲线，分析血清Cripto-1、Kim-1对肾癌患者的预测诊断价值。结果：实验组血清Cripto-1、Kim-1水平分别高于对照组，差异均有统计学意义（P<0.05）。实验组患者术后血清Cripto-1、Kim-1水平分别低于术前，差异均有统计学意义（P<0.05）。不同肿瘤直径、肿瘤分期、Fuhrman分级、有无淋巴结及远处转移的肾癌患者血清Cripto-1、Kim-1水平相比，差异均有统计学意义（P<0.05）。Cripto-1预测诊断肾癌的曲线下面积为0.795，敏感度和特异度分别为0.813和0.782；Kim-1曲线下面积为0.782，敏感度和特异度分别为0.786和0.753；Cripto-1与Kim-1联合检测曲线下面积为0.854，敏感度和特异度分别为0.896和0.824。结论：肾癌患者血清Cripto-1、Kim-1水平明显升高；血清Cripto-1、Kim-1水平与肾癌的肿瘤直径、肿瘤分期、Fuhrman分级、有无淋巴结及远处转移有关；联合检测血清Cripto-1、Kim-1对肾癌诊断有较高临床价值。

Objective: To investigate the expression and clinical significance of serum Cripto-1 and Kim-1 in patients with renal cancer. Methods: A total of 108 kidney cancer patients from January 2017 to January 2019 were selected as the research objects (experimental group). During the same period, another 60 healthy volunteers (control group) were selected. Enzyme-linked immunosorbent assay was used to detect serum Cripto-1 and Kim-1 levels in the two groups. The differences in serum Cripto-1 and Kim-1 levels of patients with different tumor diameters, tumor stages, Fuhrman grade, with or without lymph node and distant metastasis of renal cell carcinoma were analyzed. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive diagnostic value of serum Cripto-1 and Kim-1 in patients with renal cell carcinoma. Results: The serum Cripto-1 and Kim-1 levels of the experimental group were higher than those of the control group, respectively, and the difference was statistically significant (P<0.05). The postoperative serum Cripto-1 and Kim-1 levels of the experimental group were lower than those of preoperative, and the difference was statistically significant (P<0.05). The serum Cripto-1 and Kim-1 levels of renal cancer patients with different tumor diameter, tumor stage, Fuhrman grade, with or without lymph node and distant metastasis were compared with statistical significances (P<0.05). The ROC curve showed that Cripto-1 predicted the area under the curve for diagnosing kidney cancer at 0.795, and the sensitivity and specificity were 0.813 and 0.782, respectively. The area under the Kim-1 curve was 0.782, and the sensitivity and specificity were 0.786 and 0.753, respectively. The area under the Cripto-1+Kim-1 combined detection curve was 0.854, and the sensitivity and specificity were 0.896 and 0.824, respectively. Conclusion: Serum Cripto-1 and Kim-1 levels in patients with renal cell carcinoma are significantly increased. Serum Cripto-1 and Kim-1 is related to the tumor diameter, tumor stage, Fuhrman grade, with or without lymph node and distant metastasis of renal cancer. Combined detection of serum Cripto-1 and Kim-1 has high clinical value in the diagnosis of renal cell carcinoma.

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