Ching C K, Rhodes J M
University Department of Medicine, Liverpool University, UK.
Br J Cancer. 1989 Jun;59(6):949-53. doi: 10.1038/bjc.1989.202.
Previous studies have shown that sera from patients with pancreatic cancer often contain a mucus glycoprotein that expresses the oncofetal antigen galactose 1-3, N-acetyl galactosamine, which is the T blood group antigen and the binding site for the lectin peanut agglutinin (PNA). An enzyme-linked lectin assay has been developed to quantify PNA-binding glycoproteins in serum and has been evaluated as a serological test for pancreatic cancer. Sera were studied from 53 patients with pancreatic cancer and 154 controls, including benign obstructive jaundice, acute and chronic pancreatitis, chronic liver disease and inflammatory bowel disease. The enzyme-linked peanut lectin assay proved highly reproducible and has 77% sensitivity and 83% specificity for pancreatic cancer, results that are very similar to those achieved in the same sera by CA19-9 radioimmunoassay (75% sensitivity, 82% specificity with the upper limit of normal set at 37 u ml-1). CEA assay proved less useful (60% sensitivity, 47% specificity). In this study better results were obtained if an upper limit of normal of 50 u ml-1 was used for CA19-9 (75% sensitivity, 92% specificity). Combination of CA19-9 assay with the upper limit set at 50 u ml-1 and the peanut lectin assay improved the sensitivity to 85% with only a slight fall in specificity (85%). These results compare well with published results for ultrasound and CT scanning.
先前的研究表明，胰腺癌患者的血清中通常含有一种黏液糖蛋白，该蛋白表达癌胚抗原半乳糖1-3、N-乙酰半乳糖胺，这是T血型抗原，也是凝集素花生凝集素（PNA）的结合位点。已开发出一种酶联凝集素测定法来定量血清中与PNA结合的糖蛋白，并已作为胰腺癌的血清学检测方法进行了评估。研究了53例胰腺癌患者和154例对照者的血清，对照者包括良性梗阻性黄疸、急慢性胰腺炎、慢性肝病和炎症性肠病。酶联花生凝集素测定法证明具有高度可重复性，对胰腺癌的敏感性为77%，特异性为83%，这些结果与CA19-9放射免疫测定法在相同血清中获得的结果非常相似（敏感性为75%，特异性为82%，正常上限设定为37 U/ml）。癌胚抗原（CEA）测定法的作用较小（敏感性为60%，特异性为47%）。在本研究中，如果将CA19-9的正常上限设定为50 U/ml，则可获得更好的结果（敏感性为75%，特异性为92%）。将CA19-9测定法（上限设定为50 U/ml）与花生凝集素测定法相结合，可将敏感性提高到85%，而特异性仅略有下降（85%）。这些结果与已发表的超声和CT扫描结果相比效果良好。
