多种新型血清生物标志物联合应用提高胰腺疾病诊断准确性——尼泊尔博卡拉马尼帕尔教学医院病例对照研究

Improved diagnostic accuracy of pancreatic diseases with a combination of various novel serum biomarkers--case control study from Manipal Teaching Hospital, Pokhara, Nepal.

作者信息

Farooqui Mohammad Shamim, Mittal Ankush, Poudel Bibek, Mall Suhas Kumar, Sathian Brijesh, Tarique Mohammad, Farooqui Mohammad Hibban

机构信息

Department of Biochemistry, Manipal College of Medical Sciences, Pokhara, Nepal.

出版信息

Asian Pac J Cancer Prev. 2012;13(5):2171-4. doi: 10.7314/apjcp.2012.13.5.2171.

DOI:10.7314/apjcp.2012.13.5.2171

PMID:22901189

Abstract

BACKGROUND

Pancreatic cancer is a distressing disease with a miserable prospects and early recognition remains a challenge due to ubiquitous symptomatic presentation, deep anatomical location, and aggressive etiology. False positives and problems in distinguishing pancreatitis from adenocarcinoma limit the use of CA 19-9 as both disorders can present with similar symptoms and share radiographic physiognomies. This study aimed to assess the relative increase in accuracy of diagnosing the patients with chronic pancreatitis, benign neoplasm of pancreas and adenocarcinomas with CA 19-9, haptoglobin, and serum amyloid A in comparison to CA 19-9 alone.

MATERIALS AND METHODS

This hospital based case control study was carried out in the Departments of Medicine and Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal, between 1st January 2010 and 31st December 2011. The variables assessed were age, gender, serum CA19-9, serum haptoglobulin, serum Amyloid A. The data were analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version.

RESULTS

Out of 197 cases of pancreatic disease, maximum number of assumed cases were of adenocarcinoma of pancreas (95). Number of males (59) were more than females (36) in assumed cases of adenocarcinoma of pancreas. The mean values of CA19-9 raised considerably in cases of chronic pancreatitis, benign neoplasm and adenocarcinoma of pancreas when compared to controls. The highest augmention in CA19-9 values were in cases of adenocarcinoma of pancreas. The p-value indicates that in cases of chronic pancreatitis, there was not significant increase in precision of diagnosis.

CONCLUSIONS

These statistics established that haptoglobin and SAA are useful in discriminating cancer from benign conditions as well as healthy controls.

摘要

背景

胰腺癌是一种令人痛苦的疾病，预后很差，由于其症状普遍、解剖位置深以及病因侵袭性强，早期识别仍然是一项挑战。假阳性以及区分胰腺炎和腺癌的问题限制了CA 19-9的应用，因为这两种疾病可能表现出相似的症状并具有相似的影像学特征。本研究旨在评估与单独使用CA 19-9相比，联合使用CA 19-9、触珠蛋白和血清淀粉样蛋白A诊断慢性胰腺炎、胰腺良性肿瘤和腺癌患者的准确性相对提高情况。

材料与方法

本基于医院的病例对照研究于2010年1月1日至2011年12月31日在尼泊尔博卡拉马尼帕尔教学医院的内科和生物化学科进行。评估的变量包括年龄、性别、血清CA19-9、血清触珠蛋白、血清淀粉样蛋白A。数据使用Excel 2003、适用于Windows版本16.0的社会科学统计软件包R 2.8.0（SPSS公司；美国伊利诺伊州芝加哥）和EPI Info 3.5.1 Windows版本进行分析。

结果

在197例胰腺疾病病例中，假定病例数最多的是胰腺腺癌（95例）。在假定的胰腺腺癌病例中，男性（59例）多于女性（36例）。与对照组相比，慢性胰腺炎、胰腺良性肿瘤和胰腺腺癌病例中CA19-9的平均值显著升高。CA19-9值升高最高的是胰腺腺癌病例。p值表明，在慢性胰腺炎病例中，诊断准确性没有显著提高。