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
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肖卫东 E-mail:frankxwd@126.com

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江西省科技支撑计划一般项目(2008年)。


Clinical value of macrophage inhibitory cytokine-1 as a serum tumor marker for diagnosis of pancreatic cancer
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    摘要:

    目的:探讨巨噬细胞抑制因子-1(MIC-1)作为血清肿瘤标志物对胰腺癌的临床诊断价值。
    方法:采用酶联免疫法(ELISA)检测35例胰腺癌和30例胰腺良性疾病及30例健康对照者的血清MIC-1水平,并与CA19-9作比较。
    结果:胰腺癌患者的血清MIC-1水平[(1 589.8±838.5)pg/mL]显著高于胰腺良性疾病者[(400.6±104.3)pg/mL]及健康对照者[(386.1±145.5)pg/mL](均P<0.01),而胰腺良性疾病者与健康对照者之间差异无统计学意义(P>0.05)。MIC-1检测诊断胰腺癌的敏感性、特异性、阳性预测值、阴性预测值和受试者操作特征曲线下面积(AUC)分别为85.7%,93.3%,93.8%,84.9%和0.973,分别高于CA19-9的对应值74.3%,90.0%,89.6%,75.0%和0.862。两者联合检测对胰腺癌诊断的敏感性为91.4%,特异性为83.3%。在胰腺良性疾病患者中,MIC-1阳性率显著低于CA19-9阳性率(3.3% vs. 26.7%,P<0.05);伴有黄疸者的CA19-9阳性率显著高于无黄疸者(55.6% vs. 14.3%,P<0.05),而有无黄疸对MIC-1阳性率无明显影响(P>0.05)。
    结论:血清MIC-1对胰腺癌的综合诊断能力优于CA19-9,有望成为胰腺癌新的血清肿瘤标志物。

    Abstract:

    Objective:To assess the clinical value of macrophage inhibitory cytokine-1 (MIC-1) as a serum tumor marker for diagnosis of pancreatic cancer.
    Methods:Serum MIC-1 levels were measured by enzyme-linked immunosorbent assay (ELISA) in 35 patients with pancreatic cancer, 30 patients with benign pancreatic disease and 30 healthy control subjects. Meanwhile, the results of MIC-1 were compared with that of CA19-9.
    Results:The serum MIC-1 level in patients with pancreatic carcer[(1 589.8±838.5) pg/mL] was significantly higher than that in patients with benign pancreatic diseases [(400.6±104.3) pg/mL] or healthy subjects [(386.1±145.5) pg/mL] (both P<0.01), while MIC-1 levels exhibited no significant difference between the patients with benign pancreatic diseases and the healthy subjects (P>0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) of receiver operating characteristic curve of MIC-1 measurement for diagnosis of pancreatic cancer were 85.7%, 93.3%, 93.8%, 84.9% and 0.973, respectively, which were all higher than those of the corresponding values of CA19-9 (74.3%, 90.0%, 89.6%, 75.0% and 0.862, respectively). The sensitivity and specificity of combined measurement of MIC-1 and CA19-9 was 91.4% and 83.3%, respectively. The positive rate of MIC-1 was significantly lower than that of CA19-9 in patients with benign pancreatic diseases (3.3% vs. 26.7%, P<0.05). The positive rate of CA19-9 in patients with benign pancreatic diseases complicated by jaundice was significantly higher than that patients without jaundice (55.6% vs. 14.3%, P<0.05), while whether complicated by jaundice or not, it had no influence on the positive rate of MIC-1 (P>0.05).
    Conclusions:The comprehensive diagnostic ability of MIC-1 is better than CA19-9 for diagnosis of pancreatic cancer, and MIC-1 may potentially be a novel serum tumor marker of pancreatic cancer.

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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[J].中国普通外科杂志,2011,20(9):956-959.
DOI:10.7659/j. issn.1005-6947.2011.09.013

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  • 收稿日期:2011-08-05
  • 最后修改日期:2011-09-05
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  • 在线发布日期: 2011-09-15