MIC-1、OPN及CA19-9联合检测对胰腺癌的诊断价值
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摘要
目的:探讨OPN和MIC-1联合CA19-9检测胰腺癌的诊断价值.方法:ELISA检测方法检测20例胰腺癌、20例胰腺良性肿瘤、20例慢性胰腺炎、及20例正常人血清中的OPN、MIC-1以及CA19-9表达情况.比较不同组别血清中OPN、MIC-1与CA19-9表达差异的统计学意义.通过绘制ROC曲线,比较不同肿瘤标记物单独以及联合应用的诊断效能.结果:与正常组比较,胰腺癌和良性肿瘤以及慢性胰腺炎组血清中CA19-9、OPN和MIC-1均显著增高;而胰腺癌与良性肿瘤组较难分开,胰腺癌和慢性胰腺炎也不易分辨.单个指标在鉴别胰腺癌、慢性胰腺炎及胰腺良性肿瘤的检验效能有限,而OPN、MIC-1和CA19-9三者联合诊断效果优于单个肿瘤标志物,诊断胰腺癌和良性肿瘤的灵敏性和特异性分别为91.23%和92.30%;诊断胰腺癌和慢性胰腺炎的灵敏性和特异性分别为90.45%和91.89%.结论:联合检测有助于提高胰腺癌的诊断率,对于胰腺癌筛查有重要意义.
AIM: To evaluate the diagnostic value of com-bined detection of serum OPN, MIC-1 and CA19-9 in pancreatic cancer.METHODS: Serum levels of OPN, MIC-1 and CA19-9 were detected and compared in 20 pan-creatic cancer patients, 20 patients with benign pancreatic tumors, 20 patients with chronic pan-creatitis, and 20 normal controls by ELISA. By plotting the ROC curve, the diagnostic perfor-mance of these tumor markers alone or in com-bination was compared.RESULTS: Compared with the normal group, serum levels of CA19-9, OPN, and MIC-1 in the chronic pancreatitis, pancreatic cancer and be-nign groups were significantly increased. Serum levels of CA19-9, OPN, and MIC-1 were not significantly different between the pancreatic cancer, benign tumors and chronic pancreatitis groups. The ability of individual biomarkers to identify pancreatic cancer, chronic pancreatitis and benign tumors was limited, while combined detection of OPN, MIC-1 and CA19-9 was better than detection of single markers. The sensitiv-ity and specificity of combined detection of the three tumor markers were 91.23% and 92.30% in distinguishing pancreatic cancer and benign tumor, and 90.45% and 91.89% in distinguishing pancreatic cancer and chronic pancreatitis. CONCLUSION: Combined detection of serum OPN, MIC-1 and CA19-9 can help to improve the diagnosis of pancreatic cancer.
AIM: To evaluate the diagnostic value of com-bined detection of serum OPN, MIC-1 and CA19-9 in pancreatic cancer.METHODS: Serum levels of OPN, MIC-1 and CA19-9 were detected and compared in 20 pan-creatic cancer patients, 20 patients with benign pancreatic tumors, 20 patients with chronic pan-creatitis, and 20 normal controls by ELISA. By plotting the ROC curve, the diagnostic perfor-mance of these tumor markers alone or in com-bination was compared.RESULTS: Compared with the normal group, serum levels of CA19-9, OPN, and MIC-1 in the chronic pancreatitis, pancreatic cancer and be-nign groups were significantly increased. Serum levels of CA19-9, OPN, and MIC-1 were not significantly different between the pancreatic cancer, benign tumors and chronic pancreatitis groups. The ability of individual biomarkers to identify pancreatic cancer, chronic pancreatitis and benign tumors was limited, while combined detection of OPN, MIC-1 and CA19-9 was better than detection of single markers. The sensitiv-ity and specificity of combined detection of the three tumor markers were 91.23% and 92.30% in distinguishing pancreatic cancer and benign tumor, and 90.45% and 91.89% in distinguishing pancreatic cancer and chronic pancreatitis. CONCLUSION: Combined detection of serum OPN, MIC-1 and CA19-9 can help to improve the diagnosis of pancreatic cancer.
引文
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2 宗明,汤朝晖,傅晓辉,王本茂,吴孟超.血清CA19-9水平与胰腺癌转移及手术切除率关系的初步探讨.肝胆外科杂志2003;11:27-29
3 李宁,沈世强,刘建超.血清CA19-9,CA242,CEA及CA125在胰腺癌诊断和预后中的价值.中国普外基础与临床杂志2011;18:300-304
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5 邵长君,王小兵,汪毅,李茉,田海梅,单毅,赵平,张伟.血清巨噬细胞抑制因子-1在胰腺癌临床检测中的应用价值.世界华人消化杂志2007;15:3644-3648
6 Koopmann J,Buckhaults P,Brown DA,Zahurak ML,Sato N,Fukushima N,Sokoll LJ,Chan DW,Yeo CJ,Hruban RH,Breit SN,Kinzler KW,Vogelstein B,Goggins M.Serum macrophage inhibitory cytokine 1 as a marker of pancreatic and other periampullary cancers.Clin Cancer Res 2004;10:2386-2392[PMID:15073115 DOI:10.1158/1078-0432.ccr-03-0165]
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8 许崇安,胡晶晶,张学梅,高艳,李琳.CT和血清CA199联合检测在胰腺癌诊断中的价值.中国老年学杂志2012;5:2036-20389
9 Szajda SD,Waszkiewicz N,Chojnowska S,Zwierz K.Carbohydrate markers of pancreatic cancer.Bio-chem Soc Trans 2011;39:340-343[PMID:21265800 DOI:10.1042/BST0390340]
10 卢灿荣,张士武,张勇,卫勃.胰腺癌CEA,CA199,IL-6和MCP-1在血清中的表达及临床意义.科技导报2012;30:38-41
11 陈希平,孟令新,张爱莉,张红,李江涛,孙树燕.骨桥蛋白和基质金属蛋白酶9在胰腺癌中的表达及其临床意义.中国医师杂志2011;13:312-315
12 朱燕,杨其昌,刘宏斌,张晓娟,沈屹,刘曼华.骨桥蛋白、survivin及bcl-2在宫颈病变中的表达及临床意义.肿瘤防治研究2013;40:345-349
13 俞广进.骨桥蛋白(OPN)及血管内皮生长因子受体3(VEGFR-3)在胰腺癌中的表达与胰腺癌浸润、转移和预后的研究.安徽:安徽医科大学,2007
14 杨少奇,李西梅,何芳,阮继刚,杨力.胰腺癌患者外周血骨桥蛋白检测的临床意义.检验医学与临床2010;7:1281-1285
15 曾林山,肖卫东,李勇,蔡军,余永欢,李学明.巨噬细胞抑制因子-1作为血清肿瘤标志物对胰腺癌的临床诊断价值.中国普通外科杂志2011;9:126-129
2 宗明,汤朝晖,傅晓辉,王本茂,吴孟超.血清CA19-9水平与胰腺癌转移及手术切除率关系的初步探讨.肝胆外科杂志2003;11:27-29
3 李宁,沈世强,刘建超.血清CA19-9,CA242,CEA及CA125在胰腺癌诊断和预后中的价值.中国普外基础与临床杂志2011;18:300-304
4 杨盈赤.胰腺癌患者血清肿瘤标志物检测的临床价值研究.北京:中国协和医科大学,2007
5 邵长君,王小兵,汪毅,李茉,田海梅,单毅,赵平,张伟.血清巨噬细胞抑制因子-1在胰腺癌临床检测中的应用价值.世界华人消化杂志2007;15:3644-3648
6 Koopmann J,Buckhaults P,Brown DA,Zahurak ML,Sato N,Fukushima N,Sokoll LJ,Chan DW,Yeo CJ,Hruban RH,Breit SN,Kinzler KW,Vogelstein B,Goggins M.Serum macrophage inhibitory cytokine 1 as a marker of pancreatic and other periampullary cancers.Clin Cancer Res 2004;10:2386-2392[PMID:15073115 DOI:10.1158/1078-0432.ccr-03-0165]
7 张则伟,郭剑民,王新保,周立新.胰腺癌患者血清骨桥蛋白的检测及其临床意义.浙江医学2010;32:644-648
8 许崇安,胡晶晶,张学梅,高艳,李琳.CT和血清CA199联合检测在胰腺癌诊断中的价值.中国老年学杂志2012;5:2036-20389
9 Szajda SD,Waszkiewicz N,Chojnowska S,Zwierz K.Carbohydrate markers of pancreatic cancer.Bio-chem Soc Trans 2011;39:340-343[PMID:21265800 DOI:10.1042/BST0390340]
10 卢灿荣,张士武,张勇,卫勃.胰腺癌CEA,CA199,IL-6和MCP-1在血清中的表达及临床意义.科技导报2012;30:38-41
11 陈希平,孟令新,张爱莉,张红,李江涛,孙树燕.骨桥蛋白和基质金属蛋白酶9在胰腺癌中的表达及其临床意义.中国医师杂志2011;13:312-315
12 朱燕,杨其昌,刘宏斌,张晓娟,沈屹,刘曼华.骨桥蛋白、survivin及bcl-2在宫颈病变中的表达及临床意义.肿瘤防治研究2013;40:345-349
13 俞广进.骨桥蛋白(OPN)及血管内皮生长因子受体3(VEGFR-3)在胰腺癌中的表达与胰腺癌浸润、转移和预后的研究.安徽:安徽医科大学,2007
14 杨少奇,李西梅,何芳,阮继刚,杨力.胰腺癌患者外周血骨桥蛋白检测的临床意义.检验医学与临床2010;7:1281-1285
15 曾林山,肖卫东,李勇,蔡军,余永欢,李学明.巨噬细胞抑制因子-1作为血清肿瘤标志物对胰腺癌的临床诊断价值.中国普通外科杂志2011;9:126-129