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食物特异性IgG抗体辅助诊断结直肠癌的初探讨
作者:梁紫甄  杨晓燕  韩泽平  赵莹  罗允贤 
单位:广州市番禺区中心医院 检验科, 广东 广州 511400
关键词:结直肠癌 食物特异性IgG抗体 联合检测 
分类号:R392.8
出版年·卷·期(页码):2023·51·第一期(38-43)
摘要:

目的: 分析食物特异性IgG抗体与结直肠癌(CRC)的相关性,计算其与癌胚抗原(CEA)及糖类抗原CA19-9联合检测的诊断效能,初步探讨食物特异性IgG抗体对结直肠癌是否具有预测、诊断价值可能性。方法: 选取30例患者进入癌症研究组,41例患者进入息肉炎症组,35例健康体检者进入正常对照组。分析各组别的年龄、性别资料的差异;统计各组别血清中食物特异性IgG抗体的总阳性率的差异;比较各组血清中14项食物特异性IgG抗体水平;对比各组血清的CEA、CA19-9水平;通过受试者工作特征曲线比较单独检测与联合检测之间的潜在诊断性能,以确定其诊断效能。结果: 三组的年龄与性别比分别为64.10和19/11、58.0和24/17、58.4和19/16,差异无统计学意义。癌症研究组、息肉炎症组、正常对照组的食物特异性IgG抗体检测的总阳性率分别为63.33%、53.66%、31.43%,差异有统计学意义。进行14项食物特异性IgG抗体水平三组间的差异比较,有差异的过敏原项目为鸡肉、玉米、螃蟹、蘑菇、大米、虾、大豆与西红柿8项(均P<0.05)。三组CEA与CA19-9水平差异均有统计学意义(均P<0.001)。筛选后鸡肉、螃蟹、蘑菇、虾、西红柿这5个过敏原项目与CEA项目、CA19-9项目单独及联合诊断CRC性能比较,七项目联合诊断均大于单独诊断。七项目联合诊断诊断性能较优(AUC=0.925 0,灵敏度=98.68%,特异度=73.33%,Y1=0.720 2)。结论: 引入食物特异性IgG抗体项目联合CEA、CA19-9能提高CRC的诊断效能的作用。对于食物不耐受人群来讲,避免相应过敏性食物的摄入,有可能会减低患CRC的风险。

Objective: To analyze the correlation between food-specific IgG antibody and colorectal cancer(CRC), and to calculate the diagnostic efficacy combined with carcinoembryonic antigen(CEA) and carbohydrate antigen CA19-9 detection to determine whether food-specific IgG antibodies have predictive and diagnostic value for colorectal cancer.Methods: 30 patients were selected into cancer research group, 41 patients were selected into polyp inflammation group, and 35 people were selected into normal control group. The differences of age and sex in each group were analyzed. The difference of the total positive rate of food-specific IgG antibody in serum of each group were analyzed. The serum levels of 14 food-specific IgG antibodies in each group were compared. The serum CEA and CA19-9 levels of each group were compared. The potential diagnostic performance sex between single detection and combined testing was compared by subject operating characteristic curves to determine its diagnostic efficacy.Results: There were no statistically significant differences in age and gender sex between the three groups(64.10 and 19/11), (58.0 and 24/17) and(58.4 and 19/16) respectively. The total positive rate of food-specific IgG antibodies tested in the cancer study group, polyp inflammation group, and normal control group was 63.33%, 53.66%, and 31.43%, The difference was statistically significant. For 14 food-specific IgG antibodies levels compared between the three groups,differences of allergen existed in chicken, corn, crab, mushroom, rice, shrimp, beans and tomatoes(all P<0.05). The levels of CEA and CA19-9 in the three groups were compared(all P<0.001), showing statistically significant differences. However. After screening, we compared the performance of these five allergens of chicken, crab, mushroom, shrimp and tomato combined withCEA or CA19-9 or both. The combined diagnostic performance of seven items was better(AUC=0.925 0, Sensitivity=98.68%, Specificity=73.33%, Y1=0.720 2).Conclusion: The introduction of food-specific IgG antibody items combined with CEA and CA19-9 can improve the diagnostic efficiency of CRC. For people with food intolerance, avoiding allergenic foods may reduce the risk of CRC.

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