Potential roles of serum ATPase and AMPase in predicting diagnosis of colorectal cancer patients

Figures & data

Figure 1. ATP-adenosine signaling levels vary across tumor types of TCGA.

Figure 2. Association of the four-gene score with CRC in the GSE39582 dataset. (a) Violin plot of four-gene (ENTPD1, ENTPD2, ALPP, NT5E) score in normal tissues and CRC tissues (P < 0.05). (b) Kaplan–Meier survival plot of comparison between low four-gene score and high four-gene-score groups for overall survival (P < 0.05).

Table 1. Clinical and pathological data of CRC patients.

Characteristics	N	%
Sex
Male	58	66.7
Female	29	33.3
Age(years)
<60	64	73.6
≥60	23	26.4
Colon
Ascending colon	3	3.4
Transverse colon	3	3.4
Descending colon	4	4.6
Sigmoid colon	17	19.6
Rectum	44	50.6
Colon, unspecified	16	18.4
Tumor stage
Stage I+II	40	46.0
Stage III+Ⅳ	47	54.0
T classification
T1+ T2	16	18.4
T3+ T4	71	81.6
N classification
No	26	29.9
Yes	61	70.1
Metastasis
No	65	74.7
Yes	22	25.3
Vascular and neural infiltration
No	37	42.5
Yes	50	57.5

Figure 3. Levels of serum biomarkers in CRC patients and healthy controls. Levels of serum CEA (a), CA19-9 (b), ATPase (c) and AMPase (d) were elevated in 87 CRC patients compared with 48 healthy controls (*P < 0.05, ***P < 0.001).

Figure 4. Serum ATPase and AMPase levels are increased in advanced CRC patients. (a, b) The serum ATPase and AMPase levels were upregulated in 47 advanced CRC patients compared with 40 early CRC patients (*P < 0.05).

Figure 5. Effect of specific inhibitors of ENTPDases and CD73 on ATPase and AMPase levels in CRC patients. (a) Effect of specific inhibitors of ENTPDases (ARL67153 and POM-1) on ATP hydrolysis (***P < 0.001). (b) Effect of specific inhibitor of CD73 (APCP) on AMP hydrolysis (***P < 0.001).

Figure 6. ROC curves of using CEA, CA19-9, ATPase and AMPase alone in CRC patients.

Table 2. The diagnosis value of individual indicator in CRC detection.

Markers	AUC	Standard error	95%CI	Sensitivity (%)	Specificity (%)
CEA	0.869	0.029	0.811–0.926	67.8	93.5
CA19-9	0.633	0.050	0.535–0.730	72.4	47.8
ATPase	0.839	0.040	0.762–0.917	95.4	69.9
AMPase	0.769	0.045	0.680–0.859	75.9	73.9

AUC, area under curve; CI, confidence interval; CEA, carcinoembryonic antigen; CA, carbohydrate antigen.

Figure 7. ROC curves of using CEA, CA19-9, ATPase and AMPase in combination in CRC patients.

Table 3. The diagnosis value of CEA, CA19-9, ATPase and AMPase in combination to diagnose CRC.

Markers	AUC	Standard error	95%CI	Sensitivity (%)	Specificity (%)
CEA	0.869	0.029	0.811–0.926	67.8	93.5
CEA + CA19-9	0.893	0.027	0.841–0.945	69.0	93.5
CEA + ATPase	0.940	0.020	0.901–0.978	94.3	80.4
CEA + AMPase	0.933	0.021	0.893–0.974	97.7	73.9
CEA + ATPase + AMPase	0.956	0.017	0.918–0.986	92.0	87.0

AUC, area under curve; CI, confidence interval; CEA, carcinoembryonic antigen; CA, carbohydrate antigen.