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胰液KL-6浓度对诊断胰腺肿物的临床影响

Clinical Impact of the KL-6 Concentration of Pancreatic Juice for Diagnosing Pancreatic Masses.

作者信息

Matsumoto Kazuya, Takeda Yohei, Harada Kenichi, Onoyama Takumi, Kawata Soichiro, Horie Yasushi, Sakamoto Teruhisa, Ueki Masaru, Miura Norimasa, Murawaki Yoshikazu

机构信息

Department of Gastroenterology, Tottori University Hospital, 36-1 Nishi-cho, Yonago 683-8504, Japan.

Department of Pathology, Tottori University Hospital, Yonago 683-8504, Japan.

出版信息

Biomed Res Int. 2015;2015:528304. doi: 10.1155/2015/528304. Epub 2015 Sep 14.

Abstract

BACKGROUND AND AIM

Pancreatic juice cytology (PJC) is considered optimal for differentially diagnosing pancreatic masses, but the accuracy of PJC ranges from 46.7% to 93.0%. The aim of this study was to evaluate the clinical impact of measuring the KL-6 concentration of pancreatic juice for diagnosing pancreatic masses.

METHODS

PJC and the KL-6 concentration measurements of pancreatic juice were performed for 70 consecutive patients with pancreatic masses (39 malignancies and 31 benign).

RESULTS

The average KL-6 concentration of pancreatic juice was significantly higher for pancreatic ductal adenocarcinomas (PDACs) (167.7 ± 396.1 U/mL) and intraductal papillary mucinous carcinomas (IPMCs) (86.9 ± 21.1 U/mL) than for pancreatic inflammatory lesions (17.5 ± 15.7 U/mL, P = 0.034) and intraductal papillary mucinous neoplasms (14.4 ± 2.0 U/mL, P = 0.026), respectively. When the cut-off level of the KL-6 concentration of pancreatic juice was 16 U/mL, the sensitivity, specificity, and accuracy of the KL-6 concentration of pancreatic juice alone were 79.5%, 64.5%, and 72.9%, respectively. Adding the KL-6 concentration of pancreatic juice to PJC when making a diagnosis caused the values of sensitivity and accuracy of PJC to increase by 15.3% (P = 0.025) and 8.5% (P = 0.048), respectively.

CONCLUSIONS

The KL-6 concentration of pancreatic juice may be as useful as PJC for diagnosing PDACs.

摘要

背景与目的

胰液细胞学检查(PJC)被认为是鉴别诊断胰腺肿块的最佳方法,但其准确率在46.7%至93.0%之间。本研究旨在评估检测胰液中KL-6浓度对诊断胰腺肿块的临床影响。

方法

对70例连续的胰腺肿块患者(39例恶性肿瘤和31例良性肿瘤)进行了PJC及胰液KL-6浓度检测。

结果

胰腺导管腺癌(PDACs)(167.7±396.1 U/mL)和导管内乳头状黏液癌(IPMCs)(86.9±21.1 U/mL)的胰液平均KL-6浓度显著高于胰腺炎性病变(17.5±15.7 U/mL,P = 0.034)和导管内乳头状黏液性肿瘤(14.4±2.0 U/mL,P = 0.026)。当胰液KL-6浓度的临界值为16 U/mL时,仅胰液KL-6浓度的敏感性、特异性和准确性分别为79.5%、64.5%和72.9%。在诊断时将胰液KL-6浓度添加到PJC中,使PJC的敏感性和准确性值分别提高了15.3%(P = 0.025)和8.5%(P = 0.048)。

结论

胰液中KL-6浓度在诊断PDACs方面可能与PJC一样有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e22/4584219/d98662b47864/BMRI2015-528304.001.jpg

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