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联合检测血清 MUC5AC 和 CA19-9 对胰腺癌的诊断价值。

Evaluation of serum MUC5AC in combination with CA19-9 for the diagnosis of pancreatic cancer.

机构信息

Department of Gastrointestinal and Colorectal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.

Department of Hepatology, The Fifth People's Hospital of Suzhou, Suzhou, China.

出版信息

World J Surg Oncol. 2020 Feb 7;18(1):31. doi: 10.1186/s12957-020-1809-z.

Abstract

BACKGROUND

Pancreatic cancer (PC) is a highly aggressive tumor with a poor prognosis that lacks specific diagnostic markers. Mucin 5AC (MUC5AC) is a member of the mucin family, a heterogeneous group of high molecular weight, heavily glycosylated proteins that could be either membrane-bound or secreted. This multi-central study is to evaluate the performance of serum MUC5AC in combination with carbohydrate antigen 19-9 (CA19-9) for the diagnosis of PC in Asian.

METHODS

Sixty-one patients with PC (comprised of early pancreatic cancer [n = 30] and late pancreatic cancer [n = 31] patients), 29 benign control, 35 choledocholithiasis, 25 chronic pancreatitis, and 34 healthy controls, were recruited from two hospitals. Serum levels of MUC5AC were evaluated by commercial ELISA kits. CA19-9 was measured by chemiluminescence immunoassay. The cutoff value of MUC5AC was determined based on optimal sensitivity and specificity.

RESULTS

Serum MUC5AC in patients with PC (210.1 [100.5-423.8] ng/mL) presented higher levels than those in controls. The combined biomarker panel (MUC5AC and CA19-9) presented better performance and improved specificity to differentiate PC from controls (AUC 0.894; 95% CI (0.844-0.943), sensitivity 0.738, specificity 0.886) than CA19-9 (p = 0.043) or MUC5AC alone (p = 0.010); however, the latter two had no difference (p = 0.824).

CONCLUSIONS

Serum MUC5AC is a potential biomarker for PC. The combination with CA19-9 presents improved specificity and better performance.

摘要

背景

胰腺癌(PC)是一种侵袭性很强、预后不良的肿瘤,缺乏特异性的诊断标志物。黏蛋白 5AC(MUC5AC)是黏蛋白家族的一员,黏蛋白家族是一组异质性的高分子量、高度糖基化蛋白,既有膜结合型也有分泌型。这项多中心研究旨在评估血清 MUC5AC 联合糖类抗原 19-9(CA19-9)在亚洲人群中对 PC 的诊断性能。

方法

从两家医院招募了 61 名 PC 患者(包括早期胰腺癌[n = 30]和晚期胰腺癌[n = 31]患者)、29 名良性对照组、35 名胆总管结石患者、25 名慢性胰腺炎患者和 34 名健康对照组。通过商业 ELISA 试剂盒评估血清 MUC5AC 水平。通过化学发光免疫分析法测量 CA19-9。根据最佳敏感性和特异性确定 MUC5AC 的截断值。

结果

PC 患者的血清 MUC5AC 水平(210.1 [100.5-423.8]ng/mL)高于对照组。联合生物标志物(MUC5AC 和 CA19-9)的检测表现出更好的性能,提高了对 PC 与对照组的区分特异性(AUC 0.894;95%CI(0.844-0.943),敏感性 0.738,特异性 0.886),优于 CA19-9(p = 0.043)或 MUC5AC 单项检测(p = 0.010);但后两者之间无差异(p = 0.824)。

结论

血清 MUC5AC 是 PC 的一种潜在生物标志物。与 CA19-9 联合应用可提高特异性和诊断性能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e904/7006398/a759fc32694a/12957_2020_1809_Fig1_HTML.jpg

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