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半乳糖基转移酶同工酶II在胰腺癌检测中的应用:与放射学、内镜及血清学检查的比较

Galactosyltransferase isoenzyme II in the detection of pancreatic cancer: comparison with radiologic, endoscopic, and serologic tests.

作者信息

Podolsky D K, McPhee M S, Alpert E, Warshaw A L, Isselbacher K J

出版信息

N Engl J Med. 1981 May 28;304(22):1313-8. doi: 10.1056/NEJM198105283042201.

Abstract

We assessed the value of several serologic markers in detecting pancreatic carcinoma in a prospective study of 270 patients. The sensitivity and specificity of galactosyltransferase isoenzyme II (GT-II), carcinoembryonic antigen (CEA), alpha-fetoprotein, ferritin, C1q binding, and ribonuclease were determined. GT-II was the most sensitive (67.2 per cent) and specific (98.2 per cent) for discriminating between benign and malignant disease and was more sensitive and specific than CEA, the next most useful marker. Sensitivity was 64 per cent for ultrasound, 79.4 per cent for computerized body tomography (CBT), and 92.8 per cent for endoscopic retrograde cholangiopancreatography (ERCP). As a single test, only ERCP was more sensitive than GT-II, but more sensitive diagnoses resulted when GT-II was combined with ultrasound (92 per cent), CBT (88 per cent), or ERCP (100 per cent). Serum GT-II may be useful both by itself and in combination with imaging techniques in distinguishing benign from malignant pancreatic disease; however, this test does not discriminate between pancreatic carcinoma and other gastrointestinal neoplasms.

摘要

在一项针对270例患者的前瞻性研究中,我们评估了几种血清学标志物在检测胰腺癌方面的价值。测定了半乳糖基转移酶同工酶II(GT-II)、癌胚抗原(CEA)、甲胎蛋白、铁蛋白、C1q结合以及核糖核酸酶的敏感性和特异性。在区分良性和恶性疾病方面,GT-II最为敏感(67.2%)且特异(98.2%),比第二有用的标志物CEA更敏感和特异。超声检查的敏感性为64%,计算机体层摄影(CBT)为79.4%,内镜逆行胰胆管造影(ERCP)为92.8%。作为单一检查,只有ERCP比GT-II更敏感,但当GT-II与超声(92%)、CBT(88%)或ERCP(100%)联合使用时,诊断的敏感性更高。血清GT-II单独使用以及与成像技术联合使用,在区分胰腺良性和恶性疾病方面可能都有用;然而,这项检查无法区分胰腺癌与其他胃肠道肿瘤。

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