Health Management Institute, The Second Medical Center and National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China.
Division of Cancer Early Screening, Genetron Health (Beijing) Technology Co. Ltd., Beijing, China.
Iran J Med Sci. 2023 Jul;48(4):401-413. doi: 10.30476/ijms.2022.95583.2705.
Pancreatic cancer is a malignancy with high mortality due to the difficulties in early detection. We investigated and compared the diagnostic and prognostic performance of several blood biomarkers, including microRNA-25 (miR-25), carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), and carbohydrate antigen 125 (CA125).
A retrospective study was conducted at the Chinese People's Liberation Army General Hospital from May 2014 to September 2018. Serum specimens were collected, and miR-25 expression levels were measured using real-time quantitative polymerase chain reaction. Serum CA19-9, CEA, and CA125 levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses including nonparametric test, receiver operator characteristic (ROC) curves, Kaplan-Meier analysis, and subsequent log-rank test were performed with PRISM 5.0 software. Univariate and multivariate analyses were performed with the R software. P<0.05 was considered statistically significant.
A total of 250 individuals were recruited, including 75 with pancreatic ductal adenocarcinoma (PDAC), 75 with benign lesions, and 100 healthy controls. miR-25, CA19-9, CEA, and CA125 exhibited an area under the curve (AUC) of 0.88, 0.91, 0.81, and 0.76 with a sensitivity of 78.7%, 74.7%, 37.3%, and 35.7% and specificity of 91.5%, 97.0%, 98.2%, and 98.3%, respectively. The combination of miR-25 and CA19-9 further increased the sensitivity to 93.3% with a specificity of 88.5%. Stage-dependent sensitivity was observed with CA19-9, CEA, and CA125. miR-25 levels significantly stratified the prognosis by median level (4,989.97 copies/mL). CA19-9, CEA, and CA125 levels significantly stratified the prognosis by median levels. Univariate and subsequent multivariate analyses identified tumor (T) stage, CA19-9, and CA125 as independent risk factors for PDAC prognosis.
The combination of miR-25 and CA19-9 significantly enhanced the detection sensitivity of PDAC. T stage, CA19-9, and CA125 levels were independent risk factors for PDAC prognosis.
胰腺癌是一种死亡率很高的恶性肿瘤，主要是由于早期检测困难所致。我们研究并比较了几种血液生物标志物，包括 microRNA-25（miR-25）、糖链抗原 19-9（CA19-9）、癌胚抗原（CEA）和糖链抗原 125（CA125），在胰腺癌的诊断和预后中的性能。
这是一项在中国人民解放军总医院进行的回顾性研究，时间为 2014 年 5 月至 2018 年 9 月。采集血清标本，采用实时定量聚合酶链反应（PCR）检测 miR-25 的表达水平。采用酶联免疫吸附试验（ELISA）检测血清 CA19-9、CEA 和 CA125 水平。采用 PRISM 5.0 软件进行非参数检验、受试者工作特征（ROC）曲线、Kaplan-Meier 分析和随后的对数秩检验等统计分析。采用 R 软件进行单因素和多因素分析。P<0.05 为统计学显著差异。
共纳入 250 例患者，其中胰腺导管腺癌（PDAC）患者 75 例，良性病变患者 75 例，健康对照者 100 例。miR-25、CA19-9、CEA 和 CA125 的曲线下面积（AUC）分别为 0.88、0.91、0.81 和 0.76，敏感性分别为 78.7%、74.7%、37.3%和 35.7%，特异性分别为 91.5%、97.0%、98.2%和 98.3%。miR-25 和 CA19-9 的联合检测可将敏感性提高至 93.3%，特异性为 88.5%。CA19-9、CEA 和 CA125 的敏感性呈肿瘤（T）分期依赖性。miR-25 水平按中位数（4,989.97 拷贝/mL）显著分层预后。CA19-9、CEA 和 CA125 水平按中位数水平显著分层预后。单因素和随后的多因素分析确定 T 分期、CA19-9 和 CA125 为 PDAC 预后的独立危险因素。
miR-25 和 CA19-9 的联合检测显著提高了 PDAC 的检测敏感性。T 分期、CA19-9 和 CA125 水平是 PDAC 预后的独立危险因素。
