Department of Pharmacy, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Saudi J Gastroenterol. 2020 May-Jun;26(3):129-136. doi: 10.4103/sjg.SJG_447_19.
BACKGROUND/AIMS: The aim of this study is to evaluate serum mucin 3A (MUC3A) as a candidate biomarker for extrahepatic cholangiocarcinoma (EHCC).
35 Patients with EHCC, 30 patients with pancreatic cancer, 35 patients with gallbladder carcinoma and 78 patients with benign biliary disease were enrolled during January 2015 to January 2016. Serum MUC3A, carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) were measured in these patients. Pathology reports of patients with EHCC were collected.
(1) The serum levels of MUC3A (87.3 ± 10.8 ng/ml) in patients with EHCC were higher than in patients with pancreatic cancer (63.2 ± 7.7 ng/ml, P < 0.001), patients with gallbladder carcinoma (59.0 ± 10.3 ng/ml, P < 0.001) and patients with benign biliary disease (56.6 ± 13.1 ng/ml, P < 0.001). (2) ROC analysis showed that using MUC3A could clearly distinguish patients with EHCC from those without EHCC with a threshold of 73.2 ng/ml. (3) According to ROC analysis, the sensitivity, specificity, and accuracy of serum MUC3A for diagnosis of EHCC were 94.3%, 89.5% and 90.4%, respectively, which were all significantly higher than CA19-9 and CEA. (4) The serum levels of MUC3A at 1 month post-operatively in 35 patients with EHCC were decreased compared to pre-operative levels (51.8 ± 5.6 vs. 87.3 ± 10.8 ng/ml, P < 0.01). (5) Compared with 20 patients with low MUC3A levels (≤88.8 ng/ml), 15 patients with high MUC3A levels (>88.8 ng/ml) had higher percentage of lymph node metastasis (66.7% vs. 25%, P = 0.014), surrounding tissue infiltration (80% vs. 30%, P = 0.003), and UICC staging IIa-III (86.7% vs. 35%, P = 0.002).
The diagnostic efficiency for EHCC of MUC3A is obviously superior to CA19-9 and CEA, and a high level of serum MUC3A indicates a poor prognosis, therefore, MUC3A can be used as a potential diagnostic and prognostic biomarker for EHCC.
背景/目的：本研究旨在评估血清黏蛋白 3A（MUC3A）作为肝外胆管癌（EHCC）的候选生物标志物。
2015 年 1 月至 2016 年 1 月期间共纳入 35 例 EHCC 患者、30 例胰腺癌患者、35 例胆囊癌患者和 78 例良性胆道疾病患者。检测这些患者的血清 MUC3A、癌抗原 19-9（CA19-9）和癌胚抗原（CEA）水平。收集 EHCC 患者的病理报告。
（1）EHCC 患者的血清 MUC3A 水平（87.3±10.8ng/ml）高于胰腺癌患者（63.2±7.7ng/ml，P<0.001）、胆囊癌患者（59.0±10.3ng/ml，P<0.001）和良性胆道疾病患者（56.6±13.1ng/ml，P<0.001）。（2）ROC 分析表明，使用 MUC3A 可明确区分 EHCC 患者和非 EHCC 患者，截断值为 73.2ng/ml。（3）根据 ROC 分析，血清 MUC3A 诊断 EHCC 的灵敏度、特异度和准确度分别为 94.3%、89.5%和 90.4%，均显著高于 CA19-9 和 CEA。（4）35 例 EHCC 患者术后 1 个月的血清 MUC3A 水平较术前降低（51.8±5.6ng/ml 比 87.3±10.8ng/ml，P<0.01）。（5）与 20 例血清 MUC3A 水平较低（≤88.8ng/ml）的患者相比，15 例血清 MUC3A 水平较高（>88.8ng/ml）的患者淋巴结转移率更高（66.7%比 25%，P=0.014）、周围组织浸润率更高（80%比 30%，P=0.003）、UICC 分期 IIa-III 期更多（86.7%比 35%，P=0.002）。
MUC3A 对 EHCC 的诊断效率明显优于 CA19-9 和 CEA，高水平的血清 MUC3A 预示预后不良，因此，MUC3A 可作为 EHCC 的潜在诊断和预后生物标志物。
