Department of Colorectal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Clinical Laboratory, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Cancer Biomark. 2019;25(3):251-257. doi: 10.3233/CBM-190067.
There were no specific indicators for the early detection of pancreatic cancer.
To analyze the diagnostic and prognostic value of CA19-9 plus B7-H4 detection in preoperative serum or surgical tissues of patients with pancreatic cancer.
One hundred and eighty-eight patients with pancreatic cancer and 25 controls were recruited. Their preoperative serum CA19-9 level was detected chemiluminescently, and B7-H4 expression in pancreatic cancer tissues was assessed immunohistochemically. The diagnostic and prognostic utility of detecting CA19-9, B7-H4 and their combination was evaluated.
CA19-9 and B7-H4 levels were significantly upregulated in patients with pancreatic cancer compared with those in controls. The diagnostic value of combined CA19-9 plus B7-H4 detection was markedly better than that achieved from their separate detection analyzed with receiver operating characteristic curve. Sensitivity and specificity of the combined detection in the pancreatic cancer group was significantly increased compared with single detection. B7-H4 detection showed better prognostic value than detection of CA19-9. However, CA19-9 had high sensitivity and low specificity, while B7-H4 showed the opposite. The sensitivity of the combined prognosis was not significantly different to B7-H4 alone.
The combined detection of CA19-9 and B7-H4 could become a new method for the clinical diagnosis and prognosis of pancreatic cancer.
目前尚无用于胰腺癌早期检测的特异性指标。
分析术前血清或手术组织中 CA19-9 联合 B7-H4 检测对胰腺癌患者的诊断和预后价值。
纳入 188 例胰腺癌患者和 25 例对照者。采用化学发光法检测其术前血清 CA19-9 水平,免疫组织化学法检测胰腺癌组织中 B7-H4 的表达情况。评估检测 CA19-9、B7-H4 及其联合检测的诊断和预后价值。
与对照组相比,胰腺癌患者的 CA19-9 和 B7-H4 水平明显上调。与单独检测相比,CA19-9 联合 B7-H4 检测的诊断价值明显更好,采用受试者工作特征曲线进行分析。与单独检测相比,联合检测在胰腺癌组中的敏感性和特异性明显增加。B7-H4 检测的预后价值优于 CA19-9 检测。然而,CA19-9 具有高灵敏度和低特异性,而 B7-H4 则相反。联合预后的敏感性与 B7-H4 单独检测无显著差异。
CA19-9 和 B7-H4 的联合检测可能成为胰腺癌临床诊断和预后的新方法。