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瘦素联合脂联素在结直肠癌与结直肠腺瘤鉴别诊断中的应用价值

Application value of leptin combined with adiponectin in differential diagnosis of colorectal cancer and colorectal adenoma

    摘要
  • 摘要:
    目的 探讨瘦素、脂联素在结直肠癌与结直肠腺瘤鉴别诊断中的价值。
    方法 选取140例结直肠癌患者为结直肠癌组, 168例结直肠腺瘤患者为结直肠腺瘤组。另选取体检健康者170例为对照组。采用酶联免疫吸附试验(ELISA)检测血清瘦素、脂联素水平。采用Pearson相关分析法分析结直肠癌、结直肠腺瘤患者血清瘦素与脂联素的关系。采用Logistic回归模型分析影响患者发生结直肠癌的独立危险因素。采用受试者工作特征(ROC)曲线分析血清瘦素、脂联素及二者联合对结直肠癌、结直肠腺瘤的鉴别诊断价值。
    结果 对照组、结直肠腺瘤组、结直肠癌组血清瘦素水平依次为(1.52±0.46)、(2.31±0.75)、(4.56±1.36) ng/mL, 呈逐渐升高趋势，差异均有统计学意义(P < 0.05); 对照组、结直肠腺瘤组、结直肠癌组脂联素水平依次为(18.83±5.24)、(15.36±4.11)、(11.28±3.16) μg/mL, 呈逐渐降低趋势，差异均有统计学意义(P < 0.05)。Pearson相关性分析结果显示，结直肠腺瘤患者、结直肠癌患者血清瘦素与脂联素呈负相关(r=-0.493、-0.537, P均 < 0.001)。Logistic回归分析结果显示，高水平瘦素、低水平脂联素是发生结直肠癌的独立危险因素(P < 0.05)。ROC曲线显示，瘦素联合脂联素对结直肠癌与结直肠腺瘤的鉴别诊断的曲线下面积(AUC)为0.905, 灵敏度为90.00%, 特异度为82.70%。
    结论 瘦素、脂联素在结直肠癌与结直肠腺瘤患者血清中存在表达差异，瘦素、脂联素及两者联合检测在结直肠癌筛查中均具有一定的临床价值。

     

    Abstract:
    Objective To explore the value of leptin and adiponectin in the differential diagnosis of colorectal cancer and colorectal adenoma.
    Methods A total of 140 patients with colorectal cancer were selected as colorectal cancer group, and 168 patients with colorectal adenoma were selected as colorectal adenoma group. Another 170 healthy people were selected as control group. Serum leptin and adiponectin were detected by enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was used to analyze the relationship between serum leptin and adiponectin in patients with colorectal cancer and patients with colorectal adenoma. Logistic regression model was used to analyze the independent risk factors of colorectal cancer. Values of serum leptin, adiponectin and their combination in the differential diagnosis of colorectal cancer and colorectal adenoma were analyzed by receiver operating characteristic (ROC) curve.
    Results The serum leptin levels in the control group, the colorectal adenoma group and the colorectal cancer group were (1.52±0.46), (2.31±0.75) and (4.56±1.36) ng/mL respectively, which showed a gradual and significant increasing trend (P < 0.05); the serum adiponectin levels in the control group, the colorectal adenoma group and the colorectal cancer group were (18.83±5.24), (15.36±4.11) and (11.28±3.16) μg/mL respectively, which showed a gradual and significant decreasing trend (P < 0.05). Pearson correlation analysis showed that there was a negative correlation between serum leptin and adiponectin in colorectal adenoma patients and colorectal cancer patients (r=-0.493, -0.537, P < 0.001). Logistic regression analysis showed that high level of leptin and low level of adiponectin were the independent risk factors for colorectal cancer (P < 0.05). ROC curve showed that the area under the curve (AUC) of leptin combined with adiponectin in the differential diagnosis of colorectal cancer and colorectal adenoma was 0.905, the sensitivity was 90.00%, and the specificity was 82.70%.
    Conclusion There are differences in the serum levels of leptin and adiponectin in patients with colorectal cancer and patients with colorectal adenoma, and the detections of leptin, adiponectin and their combination show certain clinical value in colorectal cancer screening.

     

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