Tumor marker utility and prognostic relevance of cathepsin B, cathepsin L, urokinase-type plasminogen activator, plasminogen activator inhibitor type-1, CEA and CA 19-9 in colorectal cancer.
Tumor marker utility and prognostic relevance of cathepsin B, cathepsin L, urokinase-type plasminogen activator, plasminogen activator inhibitor type-1, CEA and CA 19-9 in colorectal cancer.
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DOI：
10.1186/1471-2407-8-194
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发表时间：
2008-07-10
期刊：
影响因子：
3.8
通讯作者：
Tulassay Z
中科院分区：
文献类型：
--
作者：
Herszényi L;Farinati F;Cardin R;István G;Molnár LD;Hritz I;De Paoli M;Plebani M;Tulassay Z
组织蛋白酶B和L（CATB、CATL）、尿激酶型纤溶酶原激活物（uPA）及其抑制剂派-1在大肠癌侵袭中起重要作用。这些蛋白酶的肿瘤标志物效用和预后相关性尚未在相同的实验环境中进行评估，并与CEA和CA-19-9进行比较。测定了56例结直肠癌患者、25例溃疡性结肠炎患者、26例结直肠腺瘤患者和35例无肿瘤对照患者的血清或血浆蛋白酶、CEA和CA 19-9水平。分别采用ELISA法和电化学发光法测定蛋白酶、CEA、CA 19-9水平，计算其敏感性、特异性和诊断准确性，并与临床病理分期进行相关性分析。结直肠癌组蛋白酶抗原水平显著高于其他组。派-1、CATB、uPA、CATL的敏感性分别为94%、82%、69%、41%，高于CEA、CA 19-9的30%、18%。派-1、CATB和uPA的准确性优于CEA或CA 19-9。派-1与CATB或uPA的组合表现出最高的敏感性值（98%）。CATB、派-1、CEA和CA 19-9水平与Dukes分期相关。CATB（P = 0.0004）、CATL（P = 0.02）、派-1（P = 0.01）和CA 19-9（P = 0.004）具有显著的预后影响。派-1（P = 0.001）、CATB（P = 0.04）和CA 19-9（P = 0.02）是独立的预后变量。在临床检测时，蛋白酶是比常用的肿瘤标志物更敏感的结直肠癌检测指标。CATB、CATL和派-1的测定对结直肠癌患者的预后有重要影响。
Cathepsin B and L (CATB, CATL), urokinase-type plasminogen activator (uPA) and its inhibitor PAI-1 play an important role in colorectal cancer invasion. The tumor marker utility and prognostic relevance of these proteases have not been evaluated in the same experimental setting and compared with that of CEA and CA-19-9. Protease, CEA and CA 19-9 serum or plasma levels were determined in 56 patients with colorectal cancer, 25 patients with ulcerative colitis, 26 patients with colorectal adenomas and 35 tumor-free control patients. Protease, CEA, CA 19-9 levels have been determined by ELISA and electrochemiluminescence immunoassay, respectively; their sensitivity, specificity, diagnostic accuracy have been calculated and correlated with clinicopathological staging. The protease antigen levels were significantly higher in colorectal cancer compared with other groups. Sensitivity of PAI-1 (94%), CATB (82%), uPA (69%), CATL (41%) were higher than those of CEA or CA 19-9 (30% and 18%, respectively). PAI-1, CATB and uPA demonstrated a better accuracy than CEA or CA 19-9. A combination of PAI-1 with CATB or uPA exhibited the highest sensitivity value (98%). High CATB, PAI-1, CEA and CA 19-9 levels correlated with advanced Dukes stages. CATB (P = 0.0004), CATL (P = 0.02), PAI-1 (P = 0.01) and CA 19-9 (P = 0.004) had a significant prognostic impact. PAI-1 (P = 0.001), CATB (P = 0.04) and CA 19-9 (P = 0.02) proved as independent prognostic variables. At the time of clinical detection proteases are more sensitive indicators for colorectal cancer than the commonly used tumor markers. Determinations of CATB, CATL and PAI-1 have a major prognostic impact in patients with colorectal cancer.
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