Hogendorf Piotr, Durczyński Adam, Kumor Anna, Strzelczyk Janusz
Department of General and Transplant Surgery, Norbert Barlicki Memorial Teaching Hospital, Medical University of Łódź, Poland.
J Invest Surg. 2012 Feb;25(1):8-13. doi: 10.3109/08941939.2011.592569.
Cyclooxygenase-2 (COX-2) may play a significant role in the development of pancreatic cancer. One of COX-2 main metabolites is prostaglandin E2 (PGE2), which is involved both in inflammation and carcinogenesis. As PGE2 is inactivated in the lungs and the liver we assumed that the best medium to assess the level of PGE2 is not peripheral but portal blood.
Fifty-seven patients with pathologically verified diagnosis of pancreatic ductal adenocarcinoma (PDAC group, n = 38) and chronic pancreatitis (CP group, n = 19) were enrolled in this study. Sample of blood from central line was collected before surgery. Intraoperatively portal vein was identified and sampled. PGE2 levels were determined using ELISA test. All the patients were followed-up for 1-35 months.
PGE2 portal blood levels in patients with PDAC were higher than in patients with CP (190.55 ± 149.86 versus 120.23 ± 132.60; p = .04). PGE2 concentration at a cut-off value of 94.46 pg/ml had a sensitivity of 91.67%, specificity of 50%, AUC = 0.631 (95% CI, 0.489-0.758).
The PGE2 portal blood levels in PDAC patients are higher than in those with CP. The PGE2 portal concentration cannot be a single marker in diagnosing PDAC due to low specificity.
环氧化酶 - 2（COX - 2）可能在胰腺癌的发生发展中起重要作用。COX - 2的主要代谢产物之一是前列腺素E2（PGE2），它参与炎症和致癌过程。由于PGE2在肺和肝脏中失活，我们推测评估PGE2水平的最佳介质不是外周血而是门静脉血。
本研究纳入了57例经病理证实诊断为胰腺导管腺癌的患者（PDAC组，n = 38）和慢性胰腺炎患者（CP组，n = 19）。术前采集中心静脉血样本。术中识别并采集门静脉样本。使用酶联免疫吸附测定（ELISA）试验测定PGE2水平。所有患者随访1 - 35个月。
PDAC患者的门静脉血PGE2水平高于CP患者（190.55±149.86对120.23±132.60；p = 0.04）。PGE2浓度截断值为94.46 pg/ml时，敏感性为91.67%，特异性为50%，曲线下面积（AUC）= 0.631（95%可信区间，0.489 - 0.758）。
PDAC患者的门静脉血PGE2水平高于CP患者。由于特异性低，门静脉PGE2浓度不能作为诊断PDAC的单一标志物。
