P53蛋白和CA_(19-9)对合并慢性胰腺炎的胰腺癌细胞学诊断的辅助作用  

Assisting value of determination of P53 protein expression and CA_(19-9) level for cytological diagnosis of pancreatic carcinoma complicated with chronic pancreatitis

作　　者：母德清[1] 彭淑牖[1] 王国凤[2] 

机构地区：[1]浙江大学医学院第二附属医院普外科,杭州市310009 [2]浙江大学医学院第二附属医院病理科,杭州市310009

出　　处：《中华肝胆外科杂志》2004年第8期526-529,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　评估P5 3蛋白和CA19 9对合并慢性胰腺炎的胰腺癌与慢性胰腺炎的辅助鉴别诊断作用。方法　 2 4例疑有慢性胰腺炎背景的胰腺癌 ,病人经影像学诊断为胰腺内肿物 ,固相放免法检测血清CA19 9,剖腹探查术时胰腺穿刺 ,穿刺标本分为细胞学检查和P5 3蛋白检测两部分。结果　细胞学诊断胰腺癌敏感性为 6 3% ,特异性为 10 0 % ,准确性为 6 3% ;P5 3蛋白分析敏感性为 4 4 % ,特异性为 10 0 % ,准确性为 73% ;CA19 9敏感性为 4 4 % ,特异性为 80 % ,准确性为 6 7%。联合检测细胞学与P5 3蛋白联合检测敏感性为 78% ,特异性为 10 0 % ,准确性为 92 % ;细胞学和CA19 9联合检测敏感性为6 7% ,特异性为 80 % ,准确性为 6 7% ;联合检测细胞学 ,P5 3和CA19 9敏感性 78% ,特异性为 80 % ,准确性为 79%。结论　与单一标志物相比联合检测有助于有慢性胰腺炎背景的胰腺癌和慢性胰腺炎的鉴别诊断。细胞学和P5 3蛋白联合检测可提供最佳诊断方法。Objective To investigate the assisting value of determination of P53 expression and CA 19-9 level for cytological diagnosis of suspected pancreatic carcinoma. Methods The pancreatic mass was determined in 24 patients with suspected pancreatic carcinoma due to chronic pancreatitis by imaging analysis. The level of serum CA 19-9 was measured by solid phase radioimmunoassay. Upon laparotomy, puncture biopsy was performed and specimens were divided into 2 parts for cytological diagnosis and detection of P53 protein. Results Cytological examination offered a sensitivity of 63%, a specificity of 100% and an accuracy of 63%. P53 protein analysis offered a sensitivity of 44%, a specificity of 100% and an accuracy of 73%. CA 19-9 determination offered a sensitivity of 44%, a specificity of 80% and an accuracy of 67%. Cytological examination in combination with P53 protein analysis showed a sensitivity of 78%, a specificity of 100% and an accuracy of 92%. Cytological examination combined with CA 19-9 determination showed a sensitivity of 67%, a specificity of 80% and an accuracy of 67%. The cytological examination in combination with P53 protein analysis and CA 19-9 determination showed a sensitivity of 78%, specificity of 80% and an accuracy of 79%. Conclusions Compared with any single test, the combined approach is more helpful for differential diagnosis of pancreatic carcinoma complicated with chronic pancreatitis. The cytological examination combined with P53 protein analysis offers the best diagnostic results.

关 键 词：P53蛋白 CA19-9 慢性胰腺炎 联合检测 胰腺癌 特异性 诊断 细胞学 标本 物相 

分 类 号：R735.9[医药卫生—肿瘤]