| Objective:Studies had reported that cysteine protease inhibitor 4(CST4)can be used as a tumor marker for gastric and colon cancers,and the main objective of this study is to evaluate the value of CST4 in diagnosing esophageal squamous cell carcinoma.Method:This study was completed in two parts,blood samples were collected from patients and health individuals in Nanjing General Hospital during September 2016 to December 2017.73 cases esophageal squamous cell carcinoma blood samples,25 cases esophageal precancerous lesion,27 cases blood samples of patients with esophageal squamous cell carcinoma after the treatment and 69 cases healthy control serum samples.The content of CST4 in serum samples of each group was detected by Elisa,and the results were analyzed by Mann-whitney U non-parametric Test and paired T test,and the levels of serum CST4 in each group were compared statistically.Result:The results showed that:? The level of serum CST4 in esophageal squamous cell carcinoma group was higher than that in healthy control group and precancerous lesions group,and the level was statistically significant(p<0.05).Compared with the traditional esophageal squamous cell carcinoma biomarkers,such as CEA,SSC and Cyfra21-1,the results showed that the diagnosis value in esophageal squamous carcinoma,CST4 was better than that of CEA and SSC,but there was no significant difference compared with cyfra21-1.CST4 as the diagnostic marker of esophageal squamous cell carcinoma,area under the curve(AUC)was 0.78(95%CI 0.703-0.845),at the cut-off point 12.38,the sensitivity of serum CST4 to the diagnosis of esophageal squamous cell carcinoma was 90.41%,the specificity was 53.62%.?In patients with esophageal squamous cell carcinoma,one months after operation,serum CST4 content was significantly lower than before operation,and the difference was statistically significant(p<0.05).?The statistical analysis of 42 cases of esophageal squamous cell carcinoma showed that serum CST4 was the highest expression in the patients with low differentiated squamous cell carcinoma,the middle differentiation was the second,and the serum CST4 expression was the lowest in the patients with high differentiated squamous cell carcinoma.Follow up the survival data of patients with esophageal squamous cell carcinoma,patients were divided into high serum CST4 group and low serum CST4 group according to the cut-off value of CST4 with 9 months,the survival curve showed that the cumulative survival rate of 9 months in high serum CST4 group was lower than that of low serum CST4,but there is no significant difference.Conclusion:Serum CST4 expression in patients with esophageal squamous cell carcinoma is higher than healthy people,it is possible to be a noninvasive diagnostic marker of esophageal squamous cell carcinoma,there is a significant difference in serum CST4 expression in patients with esophageal squamous cell carcinoma with different differentiation degree and clinical stage,which may help to diagnose the prognosis and monitor the condition of esophageal cancer. |
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