Watanabe H, Kawakami H, Yamakawa O, Satomura Y, Ohta H, Motoo Y, Okai T, Sawabu N
Department of Internal Medicine, Kanazawa University.
Rinsho Byori. 1994 Feb;42(2):127-38.
Most of the recently developed tumor antigens detected by monoclonal antibodies are sugar chains and frequently associated with blood group substance. By immunohistochemical studies, we evaluated mainly the clinical usefulness and significance of the serum assay of CA-50 classified as a type 1 sugar chain, sialyl SSEA-1 as a type 2 sugar chain, and ST-439 with an undetermined structure, as well as their clinicopathological significance. In addition, the value of measurement of CA19-9, ST-439, and SLX in pure pancreatic juice (PPJ) was investigated. Furthermore, the clinical usefulness of K-ras mutation at codon 12 (KRM) in PPJ was studied. The incidence of serum CA19-9 among tumor markers was highest in pancreatic cancer (81%), but relatively high in benign diseases. On the other hand, both serological and immunohistological studies showed that sialyl SSEA-1 and ST-439 were highly specific for the tumor, whereas they appeared in serum or tumor less frequently than CA19-9 or CA-50 carrying the type 1 sugar chain. The accuracy of the tumor markers (CA19-9, sialyl SSEA-1, and ST-439) for pancreatic cancer, was almost equal (77% to 80%) and higher than that of CEA (69%). However, a highly positive correlation between sialyl SSEA-1 and ST-439 was revealed as well as among type 1 sugar chains in malignant diseases. Therefore, we conclude that the combination assay with CA19-9 or a similar tumor marker, sialyl SSEA-1 or ST-439, and CEA would be appropriate for the screening of pancreatic cancer. When the cut off value was set as the M + 2SD of the controls, significantly elevated concentrations of CA19-9 in PPJ were found in the secretory phase in 90% of the patients with pancreatic cancer (PC) and 66% of the patients with chronic pancreatitis (CP). Although increased concentrations of CA19-9 in PPJ have no cancer specificity, measurement of CA19-9 in PPJ can be used as a sensitive marker for some pancreatic disorders. On the other hand, concentrations of ST-439 and SLX in PPJ were significantly increased only in PC, and their incidences were 50% and 40%, respectively. They have a high tumor-specificity, but their incidences were not as high as initially expected.(ABSTRACT TRUNCATED AT 400 WORDS)
最近通过单克隆抗体检测到的大多数肿瘤抗原都是糖链，并且常常与血型物质相关。通过免疫组织化学研究，我们主要评估了血清检测CA - 50（归类为1型糖链）、唾液酸化SSEA - 1（2型糖链）和结构未明的ST - 439的临床实用性和意义，以及它们的临床病理意义。此外，还研究了纯胰液（PPJ）中CA19 - 9、ST - 439和SLX检测的价值。此外，还研究了PPJ中第12密码子K - ras突变（KRM）的临床实用性。在肿瘤标志物中，血清CA19 - 9在胰腺癌中的发生率最高（81%），但在良性疾病中也相对较高。另一方面，血清学和免疫组织学研究均表明，唾液酸化SSEA - 1和ST - 439对肿瘤具有高度特异性，然而它们在血清或肿瘤中出现的频率低于携带1型糖链的CA19 - 9或CA - 50。胰腺癌肿瘤标志物（CA19 - 9、唾液酸化SSEA - 1和ST - 439）的准确性几乎相同（77%至80%），高于癌胚抗原（CEA）（69%）。然而，在恶性疾病中，唾液酸化SSEA - 1与ST - 439之间以及1型糖链之间显示出高度正相关。因此，我们得出结论，CA19 - 9或类似肿瘤标志物、唾液酸化SSEA - 1或ST - 439与CEA的联合检测适用于胰腺癌的筛查。当将临界值设定为对照组的M + 2SD时，90%的胰腺癌（PC）患者和66%的慢性胰腺炎（CP）患者在分泌期的PPJ中发现CA19 - 9浓度显著升高。虽然PPJ中CA19 - 9浓度升高无癌症特异性，但PPJ中CA19 - 9的检测可作为某些胰腺疾病的敏感标志物。另一方面，PPJ中ST - 439和SLX的浓度仅在PC中显著升高，其发生率分别为50%和40%。它们具有高度肿瘤特异性，但发生率不如最初预期的高。（摘要截断于400字）
