作者：罗锦文1,2，李新春2，雷强2，陈淮2，胡文清2

单位：1.广州医科大学附属第五医院 影像科，广东 广州 510700； 2.广州医科大学附属第一医院 放射科，广东 广州 510120

Authors:  LUO Jinwen1,2，LI Xinchun2，LEI Qiang2，CHEN Huai2，HU Wenqing2

Unit: 1.Department of Imaging Department, the Fifth Affiliated Hospital of Guangzhou Medical university, Guangzhou 510700, Guangdong, China;  2.Department of Radiology, the First Affiliated Hospital of Guangzhou Medical university, Guangzhou 510120, Guangdong, China

摘要：

目的  探讨MRI/CT与血清胰岛素样生长因子结合蛋白-3(insulin-like growth factor binding protein 3, IGFBP-3)、脱嘌呤脱嘧啶核酸内切酶1自身抗体(apurinic/ apyrimidinic endonuclease 1autoantibodies,  APE1-AAbs) 联合应用在结直肠癌诊断中的价值。方法  选取2015年4月-2018年2月在我院行手术治疗127例经手术病理证实的结直肠癌患者作为研究对象,患者行MRI/CT检查,选择同期在我院进行健康体检的75例健康体检者为对照组,检测并比较血清IGFBP-3、APE1-AAbs水平,分析MRI/CT结果,根据血清IGFBP-3、APE1-AAbs检测水平将所有患者进行分组,比较MRI/CT在不同分组中的诊断效能。结果  结直肠癌组患者血清IGFBP-3为(2.86±1.31)μg/ml, APE-AAbs为2.79(1.14～9.61); 对照组研究对象血清IGFBP-3为(4.72±1.14)μg/ml, APE-AAbs为1.91(0.78～5.52),结直肠癌组患者血清IGFBP-3水平显著低于对照组, APE-AAbs水平显著高于对照组(P<0.05)。根据血清IGFBP-3、APE1-AAbs检测水平将所有患者分为IGFBP-3/APE1-AAbs异常组(45例)和IGFBP-3/APE1-AAbs正常组(82例), IGFBP-3/APE1-AAbs正常组中MRI/CT诊断准确度为66.67%; IGFBP-3/APE1-AAbs异常组中MRI/CT诊断准确度为89.02%,比较差异具有均具有统计学意义(P<0.05)。结论  结直肠癌患者血清IGFBP-3呈低表达,APE1-AAbs呈高表达,两者血清水平检测对结直肠癌均具有辅助诊断价值,此外,MRI/CT在IGFBP-3降低或APE1-AAbs升高组结直肠癌的诊断中准确性更高,MRI/CT影像学检查和血清IGFBP-3、APE1-AAbs水平检测联合应用可提高结直肠癌的诊断效能。

关键词： 结直肠癌; 诊断; 术前分期; 电子计算机断层扫描; 磁共振成像; 胰岛素样生长因子结合蛋白-3; 脱嘌呤脱嘧啶核酸内切酶1自身抗体

Abstract：

Objective  To evaluate the value of MRI / CT combined with serum insulin-like growth factor binding protein-3 (IGFBP-3) and apurinic/apyrimidinic endonuclease-1 autoantibodies (APE1-AAbs) in the diagnosis of colorectal cancer. Methods  From April 2015 to February 2018, 127 patients with colorectal cancer confirmed by surgery and pathology were selected as the study subjects. MRI / CT examination was performed in the patients. 75 healthy people who underwent physical examination in our hospital at the same time were selected as the control group. The serum levels of IGFBP-3 and APE1-Aabs were detected and compared, and the results of MRI / CT were analyzed. All patients were grouped according to the serum levels of IGFBP -3 and APE1-AAbs, and the diagnostic efficacy of MRI/CT in different groupings was compared. Results  The serum levels of IGFBP-3 and APE-AAbs in patients with colorectal cancer were (2.86±1.31) ug/ml and 2.79 (1.14~9.61) respectively. The serum levels of IGFBP-3 and APEAAbs in the control group were (4.72±1.14) ug/ml and 1.91 (0.78~5.52) respectively. The serum levels of IGFBP-3 in the colorectal cancer group were significantly lower than that in the control group, the level of APE-AAbs was significantly higher than that of the control group (P<0.05). All patients were divided into IGFBP-3/APE1-AAbs abnormal group (45 cases) and IGFBP-3/APE1-AAbs normal group (82 cases), the diagnostic accuracy of MRI/CT was 66.67% in IGFBP-3/APE1-AAbs normal group, and 89.02% in IGFBP-3/APE1-AAbs abnormal group. Academic significance (P<0.05). Conclusion  The serum levels of IGFBP-3 and APE1-AAbs in patients with colorectal cancer are low and high. Both of them are of value in assistant diagnosis of colorectal cancer. In addition, MRI/CT is more accurate in diagnosis of colorectal cancer in patients with IGFBP-3 decrease or APE1-AAbs increase, MRI/CT imaging and serum levels of IGFBP-3 and APE1-AAbs are higher. Combined detection can improve the diagnostic efficiency of colorectal cancer.

Key Words:  colorectal cancer; computed tomography; magnetic resonance imaging; insulin-like growth factor binding protein-3; autoantibody to depurine endonuclease-1