Chung Mathew H, Gupta Rishab K, Bilchik Anton J, Ye Wei, Yee Reynold, Morton Donald L
Roy E. Coats Research Laboratories of the John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California, USA.
Curr Surg. 2002 Mar-Apr;59(2):194-8. doi: 10.1016/s0149-7944(01)00594-3.
Because TA90, a 90-kDa immunogenic tumor-associated antigen, is expressed by pancreatic cancer cells, we hypothesized that the serum level of its immune complex with IgG (TA90-IC) might be a useful marker for diagnosis of pancreatic malignancy. We also wanted to compare TA90-IC with CA 19-9 in the diagnosis of pancreatic cancer.
We undertook a retrospective study of prospectively collected sera from patients with histopathologically proven pancreatic malignancies. Patient sera were analyzed for TA90-IC and CA 19-9. Sera of sex-matched and age-matched healthy volunteers (controls) were analyzed for TA90-IC. The study was conducted at a tertiary medical center. Twenty-one patients with pancreatic malignancies and 29 controls, from whom sera had been obtained and cryopreserved, were included. A positive TA90-IC level was defined as an optical density >/= 0.410 at 405 nm following an enzyme-linked immunosorbent assay based on a murine monoclonal antibody. CA 19-9 levels were determined by immunoradiometric assay performed at outside laboratories (normal range, 0 to 37 U/mL).
Of the 21 patients, 14 had positive TA90-IC levels and 18 had increased CA 19-9 levels (67% vs 86%; p = 0.157). The TA90-IC levels were significantly higher in the cancer group than in the control group (p = 0.0003). Of the 3 patients with normal CA 19-9 levels, 2 had positive TA90-IC levels. The combination of both markers identified 95% of patients with pancreatic malignancy, a significantly higher diagnostic rate than that of either marker alone (p = 0.014). TA90-IC sensitivity was higher for stage II and III disease than for stage IV disease (82% vs 50%).
TA90-IC assay may improve the prediction of pancreatic malignancy when used in combination with CA 19-9 levels. Because TA90-IC appears to have improved diagnostic accuracy with smaller tumor burden, the role of TA90-IC as an adjunct to CA 19-9 in screening and monitoring progression of early disease warrants further investigation.
由于90 kDa免疫原性肿瘤相关抗原TA90由胰腺癌细胞表达，我们推测其与IgG的免疫复合物（TA90-IC）的血清水平可能是诊断胰腺恶性肿瘤的有用标志物。我们还想在胰腺癌诊断中比较TA90-IC和CA 19-9。
我们对前瞻性收集的经组织病理学证实为胰腺恶性肿瘤患者的血清进行了回顾性研究。分析患者血清中的TA90-IC和CA 19-9。分析性别和年龄匹配的健康志愿者（对照）血清中的TA90-IC。该研究在一家三级医疗中心进行。纳入了21例胰腺恶性肿瘤患者和29名对照，已获取并冷冻保存了他们的血清。基于鼠单克隆抗体的酶联免疫吸附测定后，TA90-IC阳性水平定义为405 nm处光密度≥0.410。CA 19-9水平由外部实验室进行免疫放射分析测定（正常范围，0至37 U/mL）。
21例患者中，14例TA90-IC水平阳性，18例CA 19-9水平升高（67%对86%；p = 0.157）。癌症组的TA90-IC水平显著高于对照组（p = 0.0003）。在3例CA 19-9水平正常的患者中，2例TA90-IC水平阳性。两种标志物联合可识别95%的胰腺恶性肿瘤患者，诊断率显著高于单独使用任何一种标志物（p = 0.014）。TA90-IC对II期和III期疾病的敏感性高于IV期疾病（82%对50%）。
TA90-IC检测与CA 19-9水平联合使用时，可能会改善胰腺恶性肿瘤的预测。由于TA90-IC在肿瘤负荷较小时似乎具有更高的诊断准确性，TA90-IC作为CA 19-9在早期疾病筛查和监测进展中的辅助手段的作用值得进一步研究。
