一种通过超声内镜引导下细针穿刺获取的冲洗液中生物标志物的新型胰腺癌诊断模型。
A Novel Diagnostic Model of Biomarkers in the Washing Fluid Obtained by EUS-FNA in Pancreatic Cancer.
作者信息
Li Chen-Fan, Hao Lan-Xiang, Chen Yi-Jia, Lin En-De, Zhang Chun-Ping, Wu Li-Hua, Liao Xu-Ying, Zhou Jia-Li, Zhu Jian-Hui, Zhan Ling-Hui, Liang Xian-Ming, Hu Yi-Qun
机构信息
Department of Medical Oncology, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen, 361020, China.
Department of Pathology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361102, China.
出版信息
J Gastrointest Cancer. 2025 Mar 27;56(1):89. doi: 10.1007/s12029-025-01209-9.
BACKGROUND AND AIMS
Currently, there are no biomarkers with high accuracy in the detection of pancreatic cancer. This article aims to evaluate the performance of a novel diagnostic model based on a combination of biomarkers in the washing fluid obtained by EUS-FNA with imaging examination in pancreatic cancer.
METHODS
This study included 59 patients with pancreatic lesions who underwent EUS-FNA and were categorized into malignant and benign groups on the basis of pathology diagnosis. The levels of CEA, CA19-9, CA125, CA724, CYFRA 21-1, IMP3, SMAD4, and S100P in EUS-FNA washing fluid were detected by ELISA. We attempted to construct a new diagnostic method by combining the above biomarkers with EUS, CT, MRI, and PET-CT.
RESULTS
CEA, CA19-9, CA724, CA125, and CYFRA 21-1 showed statistical significance in the diagnosis of pancreatic cancer (AUC > 0.7, p < 0.05). CA724 had a specificity of up to 100% in the group with positive EUS diagnosis. If at least two positive imaging results (EUS/CT/MRI/PET-CT) combined with at least one tumor marker (CEA/CA199/CA724) in series, the sensitivity was 88.57% and the specificity was 91.67%.
CONCLUSIONS
Combining the tumor markers CEA, CA19-9, CA724, CA125, and CYFRA 21-1 in the washing fluid of EUS-FNA with commonly used imaging methods can help distinguish benign and malignant pancreatic lesions.
背景与目的
目前，在胰腺癌检测中尚无具有高准确性的生物标志物。本文旨在评估一种基于超声内镜引导下细针穿刺（EUS-FNA）获取的冲洗液中生物标志物组合并结合影像学检查的新型诊断模型在胰腺癌中的性能。
方法
本研究纳入59例接受EUS-FNA检查的胰腺病变患者，并根据病理诊断分为恶性组和良性组。采用酶联免疫吸附测定（ELISA）法检测EUS-FNA冲洗液中癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、糖类抗原125（CA125）、糖类抗原724（CA724）、细胞角蛋白19片段抗原21-1（CYFRA 21-1）、胰岛素样生长因子Ⅱ信使核糖核酸结合蛋白3（IMP3）、SMAD4蛋白和S100P蛋白的水平。我们尝试通过将上述生物标志物与超声内镜（EUS）、计算机断层扫描（CT）、磁共振成像（MRI）和正电子发射断层显像/X线计算机体层成像（PET-CT）相结合来构建一种新的诊断方法。
结果
CEA、CA19-9、CA724、CA125和CYFRA 21-1在胰腺癌诊断中具有统计学意义（曲线下面积[AUC]＞0.7，p＜0.05）。在EUS诊断为阳性的组中，CA724的特异性高达100%。如果至少两个影像学检查结果（EUS/CT/MRI/PET-CT）为阳性且至少一个肿瘤标志物（CEA/CA199/CA724）为阳性串联起来，则敏感性为88.57%，特异性为91.67%。
结论
将EUS-FNA冲洗液中的肿瘤标志物CEA、CA19-9、CA724、CA125和CYFRA 21-1与常用影像学方法相结合，有助于鉴别胰腺病变的良恶性。
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