血清胰岛素样生长因子结合蛋白2（IGFBP2）和间皮素（MSLN）作为胰腺癌的诊断和预后生物标志物。
Serum IGFBP2 and MSLN as diagnostic and prognostic biomarkers for pancreatic cancer.
作者信息
Kendrick Zachary W, Firpo Matthew A, Repko Robert C, Scaife Courtney L, Adler Douglas G, Boucher Kenneth M, Mulvihill Sean J
机构信息
Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
出版信息
HPB (Oxford). 2014 Jul;16(7):670-6. doi: 10.1111/hpb.12199. Epub 2013 Dec 6.
BACKGROUND
Identification of diagnostic and prognostic biomarkers is a research priority for the improved management of pancreatic ductal adenocarcinoma (PDAC). Insulin-like growth factor binding protein 2 (IGFBP2) and mesothelin (MSLN) have shown potential as serum biomarkers in other cancers, but have not been adequately studied in PDAC.
METHODS
Serum IGFBP2 and MSLN levels were quantified by enzyme-linked immunosorbent assay (ELISA) in a cohort of 84 PDAC patients, 84 healthy control subjects and 40 chronic pancreatitis (ChPT) patients. Regression models related IGFBP2 and MSLN levels to diagnosis, gender, age, stage and survival.
RESULTS
IGFPB2 and MSLN serum levels were diagnostic for PDAC in age-adjusted models (P = 0.032 and P = 0.002, respectively) when compared with ChPT and healthy control samples. At a 95% specificity threshold, the sensitivity for IGFBP2 was 22% and the sensitivity for MSLN was 17%. Neither protein approached the diagnostic accuracy of CA 19-9. However, IGFBP2 or MSLN or both correctly identified 18 of the 28 samples misidentified by CA 19-9. In age-adjusted models, neither serum IGFBP2 (P = 0.36) nor MSLN (P = 0.29) were significant predictors of survival.
DISCUSSION
Serum IGFBP2 and MSLN are weak diagnostic classifiers individually, but may be useful in a diagnostic biomarker panel.
背景
鉴定诊断和预后生物标志物是改善胰腺导管腺癌（PDAC）管理的研究重点。胰岛素样生长因子结合蛋白2（IGFBP2）和间皮素（MSLN）在其他癌症中已显示出作为血清生物标志物的潜力，但在PDAC中尚未得到充分研究。
方法
通过酶联免疫吸附测定（ELISA）对84例PDAC患者、84例健康对照者和40例慢性胰腺炎（ChPT）患者的队列中的血清IGFBP2和MSLN水平进行定量。回归模型将IGFBP2和MSLN水平与诊断、性别、年龄、分期和生存相关联。
结果
与ChPT和健康对照样本相比，在年龄调整模型中，IGFPB2和MSLN血清水平对PDAC具有诊断意义（分别为P = 0.032和P = 0.002）。在95%特异性阈值下，IGFBP2的敏感性为22%，MSLN的敏感性为17%。这两种蛋白均未达到CA 19-9的诊断准确性。然而，IGFBP2或MSLN或两者正确识别出了CA 19-9误判的28个样本中的18个。在年龄调整模型中，血清IGFBP2（P = 0.36）和MSLN（P = 0.29）均不是生存的显著预测因子。
讨论
血清IGFBP2和MSLN单独作为诊断分类指标较弱，但可能在诊断生物标志物组合中有用。
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