血清和组织PLAC1在结肠癌诊断和判断淋巴结转移风险中的临床价值-东南大学学报医学版

血清和组织PLAC1在结肠癌诊断和判断淋巴结转移风险中的临床价值

单位：大连市第三人民医院普通外科一病房, 辽宁大连 116000

分类号：R735.35

出版年·卷·期（页码）：2022·41·第一期（102-108）

摘要：

目的：研究血清和组织胎盘特异性基因1（PLAC1）在结肠癌诊断和判断淋巴结转移风险中的临床价值。方法：于2021年3月从TCGA数据库下载RNA-Seq表达数据和患者临床特征资料进行生物信息学分析。另外选取2018年3月至2021年3月在我院完成结肠癌根治术的151例结肠癌患者作为研究对象（结肠癌组），另外选取150例非癌患者的血清样本作为正常组，通过免疫组化法和酶联免疫吸附测定法检测PLAC1在组织和血清中的表达情况。结果：通过生物信息学分析，肿瘤组织中PLAC1的表达量明显高于正常组织（P<0.01），且高表达的PLAC1与远处转移、淋巴结转移、临床分期、总生存预后和无病生存预后有关（P<0.05）。与癌旁正常组织相比，肿瘤组织中PLAC1蛋白阳性表达率显著升高[64.90%（98/151）vs.18.54%（28/151），P<0.05]。正常组和结肠癌组血清PLAC1水平分别为42.51（22.90，62.85） ng·ml^-1和86.70（45.50，210.00） ng·ml^-1，结肠癌组患者血清PLAC1水平明显高于正常组（P<0.05）。此外，组织PLAC1高表达与肿瘤直径>5 cm、淋巴结转移和TNM Ⅲ~Ⅳ分期有关（P<0.05）；而血清PLAC1水平亦与淋巴结转移和TNM Ⅲ~Ⅳ分期有关（P<0.05）。经受试者工作特征（ROC）曲线分析，血清PLAC1水平诊断结肠癌的曲线下面积（AUC）为0.962（95%CI：0.934~0.989），预测结肠癌淋巴结转移的AUC为0.868（95%CI：0.828~0.908）。结论：结肠癌组织和血清PLAC1水平普遍升高，这与淋巴结转移和疾病进展有关；检测血清PLAC1水平对于结肠癌诊断和预测淋巴结转移风险能提供一定的可参考信息。

Objective: To investigate the clinical value of serum or tissue placenta-specific 1(PLAC1) in the diagnosis of colon cancer and the judgment of lymph node metastasis risk. Methods: Bioinformatics analysis by downloading RNA-Seq expression data and patient clinical characteristics from the TCGA database in march 2021. From March 2018 to March 2021, 151 patients underwent resection of colon cancer and pathologically diagnosed colorectal cancer in our hospital were selected as the colon cancer group. Another 150 cases without any cancer were also selected into this study as the normal group. The expression of PLAC1 in colon cancer tissues or serum samples was analyzed by immunohistochemistry or ELISA. Results: The expression of PLAC1 in tumor tissue was significantly higher than that in normal tissue by bioinformatics analysis(P<0.01), and the high expression of PLAC1 was associated with distant metastasis, lymph node metastasis, clinical stage, total survival and disease-free survival(P<0.05). The positive expression rate of PLAC1 protein in tumor tissues was significantly higher than that in the para-cancerous normal tissues[64.90%(98/151) vs. 18.54%(28/151), P<0.05]. The serum PLAC1 level in the normal group and colon cancer group were 42.51(22.90,62.85) ng·ml^-1 and 86.70(45.50,210.00) ng·ml^-1,respectively. And the serum PLAC1 level in the colon cancer group was significantly higher than that in the normal group(P<0.05). In addition, high expression of PLAC1 of tissues was associated with tumor diameter >5 cm, lymph node metastasis and TNM Ⅲ~Ⅳ stage(P<0.05), and the serum PLAC1 level was associated with lymph node metastasis and TNM Ⅲ-Ⅳ stage(P<0.05). By ROC curve, the AUC of serum PLAC1 level for the diagnosis of colon cancer was 0.962(95%CI:0.934-0.989) and the AUC for the prediction of lymph node metastasis was 0.868(95%CI:0.828-0.908). Conclusion: The levels of PLAC1 in colon cancer tissues and serum are generally elevated, which are related to lymph node metastasis and disease progression. The detection of serum PLAC1 level can provide certain reference information for the diagnosis of colon cancer and prediction of lymph node metastasis risk.

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