Takasaki H, Uchida E, Tempero M A, Burnett D A, Metzgar R S, Pour P M
Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha 68105.
Cancer Res. 1988 Mar 15;48(6):1435-8.
The serum levels of CA 19-9 and DU-PAN-2 antigens and their expression in tumor tissue were examined in 22 pancreatic cancer patients and the results were correlated with the Lewis (Le) blood group phenotypes of the individuals. In tumor tissue, CA 19-9 was expressed in 17 of 22 (77%) specimens. The negative cases included three patients with Lea-b-, one with Lea+b- and the other with Lea-b+ phenotypes. DU-PAN-2 antigen was expressed in 20 of 22 (91%) cancer tissues. The two DU-PAN-2-negative cases were CA 19-9-positive. The combination of two markers increased the sensitivity to 100%. In the serum, CA 19-9 level was elevated (greater than 37 U/ml) in 16 of 21 (73%) cases. All Lea-b- patients had values less than 37 U/ml. An elevated level of DU-PAN-2 (greater than 300 U/ml) was detected in 14 of 21 (67%) patients including three cases with Lea-b- type. In only one patient were both antigens below the cutoff levels so that the combination of two biomarkers elevated the sensitivity to 95%. The study indicated that the cocktail of 19-9 and DU-PAN-2 antibodies might increase the sensitivity and specificity for clinical diagnosis of pancreatic cancer. In 19 of 21 (90%) cases, the serum CA 19-9 level correlated with the expression of the antigen in the cancer tissue. Discrepancy was seen in two cases; one patient had an elevated level of CA 19-9 in the serum, but lacked this antigen in the cancer cells. In the second case, the situation was reversed. For DU-PAN-2, positive correlation was seen in 14 of 21 (67%) cases. Six of seven patients with low DU-PAN-2 levels expressed the antigen in their tumor cells, and one patient with DU-PAN-2-negative cancer tissue had an elevated level of this marker in the serum. Thus, CA 19-9 expression in serum corresponded more closely to expression in tissue than did that of DU-PAN-2 antigen. The serum levels of these antigens, however, is likely due to multiple factors, only one of which is the qualitative and quantitative expression of the antigens in tumors.
对22例胰腺癌患者检测了血清中CA 19-9和DU-PAN-2抗原水平及其在肿瘤组织中的表达，并将结果与个体的Lewis（Le）血型表型进行关联。在肿瘤组织中，22份标本中有17份（77%）表达CA 19-9。阴性病例包括3例Lea-b-型患者、1例Lea+b-型患者和1例Lea-b+型患者。22份癌组织中有20份（91%）表达DU-PAN-2抗原。2例DU-PAN-2阴性病例CA 19-9呈阳性。两种标志物联合使用可将敏感性提高到100%。血清中，21例中有16例（73%）CA 19-9水平升高（大于37 U/ml）。所有Lea-b-型患者的值均低于37 U/ml。21例患者中有14例（67%）检测到DU-PAN-2水平升高（大于300 U/ml），其中包括3例Lea-b-型病例。仅1例患者两种抗原均低于临界值，因此两种生物标志物联合使用可将敏感性提高到95%。该研究表明，19-9和DU-PAN-2抗体联合使用可能会提高胰腺癌临床诊断的敏感性和特异性。21例中有19例（90%）血清CA 19-9水平与癌组织中抗原表达相关。有2例出现差异；1例患者血清中CA 19-9水平升高，但癌细胞中缺乏该抗原。在第二例中，情况相反。对于DU-PAN-2，21例中有14例（67%）呈正相关。7例DU-PAN-2水平低的患者中有6例肿瘤细胞表达该抗原，1例DU-PAN-2阴性癌组织患者血清中该标志物水平升高。因此，血清中CA 19-9的表达比DU-PAN-2抗原的表达与组织中的表达更密切相关。然而，这些抗原的血清水平可能受多种因素影响，其中只有一个因素是肿瘤中抗原的定性和定量表达。
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