Liao Wei-Chih, Wu Ming-Shiang, Wang Hsiu-Po, Tien Yu-Wen, Lin Jaw-Town
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Pancreas. 2009 May;38(4):422-6. doi: 10.1097/MPA.0b013e318198281d.
A prior study suggested serum heat shock protein 27 (HSP27) as a potential marker for pancreatic carcinoma, but its accuracy in differentiating cancer from chronic pancreatitis was not evaluated. We aimed to analyze HSP27 levels in pancreatic carcinoma, chronic pancreatitis, and healthy subjects and assess its diagnostic efficacy.
Pretreatment serums from 58 pancreatic carcinoma, 44 chronic pancreatitis, and 102 control subjects were collected. Serum HSP27 and carbohydrate antigen 19-9 (CA19-9) levels were analyzed using an enzyme-linked immunosorbent assay and radioimmunoassay, respectively.
Heat shock protein 27 levels were significantly higher in cancer and pancreatitis compared with control (P < 0.001 for both), but no significant difference was noted between cancer and pancreatitis (P = 0.978). By logistic regression, HSP27 was a significant predictor of differentiation between cancer and control (P < 0.0001) but not between cancer and pancreatitis (P = 0.885). At a cutoff of 1650 ng/L, the sensitivity and specificity for differentiating cancer from healthy control were 62.1% and 95.1%, respectively. Receiver operating characteristic analyses showed a greater area under curve for CA19-9 compared with HSP27 in differentiating between cancer and control (0.92 and 0.84, respectively, P = 0.014).
Serum HSP27 is increased in both chronic pancreatitis and pancreatic carcinoma. It should not be recommended as a diagnostic marker for pancreatic carcinoma.
先前的一项研究表明血清热休克蛋白27(HSP27)可能是胰腺癌的一个潜在标志物,但未评估其在区分癌症与慢性胰腺炎方面的准确性。我们旨在分析胰腺癌、慢性胰腺炎和健康受试者中HSP27的水平,并评估其诊断效能。
收集了58例胰腺癌患者、44例慢性胰腺炎患者和102例对照受试者的治疗前血清。分别采用酶联免疫吸附测定法和放射免疫测定法分析血清HSP27和糖类抗原19-9(CA19-9)水平。
与对照组相比,癌症组和胰腺炎组的热休克蛋白27水平均显著升高(两者P均<0.001),但癌症组与胰腺炎组之间无显著差异(P = 0.978)。通过逻辑回归分析,HSP27是区分癌症与对照组的显著预测因子(P < 0.0001),但不是区分癌症与胰腺炎的预测因子(P = 0.885)。在截断值为1650 ng/L时,区分癌症与健康对照的敏感性和特异性分别为62.1%和95.1%。受试者工作特征分析显示,在区分癌症与对照组方面,CA19-9的曲线下面积大于HSP27(分别为0.92和0.84,P = 0.014)。
慢性胰腺炎和胰腺癌患者的血清HSP27均升高。不建议将其作为胰腺癌的诊断标志物。