胰腺癌血清学诊断的临床评价  

A clinical evaluation of serological diagnosis for pancreatic cancer

作　　者：赵晓晏[1] 于世远[1] 达四平[1] 白莉[1] 郭小钟 马笑波 戴小晶 王源敏 

机构地区：[1]第三军医大学附属新桥医院消化内科

出　　处：《第三军医大学学报》1996年第1期26-29,共4页Journal of Third Military Medical University

基　　金：全军"八五"攻关项目

摘　　要：应用制备的胰腺癌胚抗原（ＰＯＡ）、小分子量胰腺癌胚抗原（ｍＰＯＡ）、结肠胰腺癌相关抗原（ＰＣＡＡｃ）、胰腺特异性抗原（ＰａＡ）、人弹力蛋白酶Ⅰ（ＨＥＰⅠ）以及ＣＡ１９－９、弹力蛋白酶Ⅰ（ＥⅠ）、癌胚抗原（ＣＥＡ）、α，抗胰蛋白酶（α１ＡＴ）检测药盒和建立的甘氨酰－脯氨酸二肽氨基肽酶（ＧＰＤＡ）、核糖核酸酶及同功酶Ⅰ、Ⅲ（ＲＮａｓｅ、ＲＮａｓｅⅠ、ＲＮａｓｅⅢ）等１３项指标对包括胰腺癌在内的７６３例血清标本进行检测以探讨血清学检测对胰腺癌的诊断价值。结果表明，血清ＰＯＡ、ｍＰＯＡ、ＰＣＡＡｃ、ＰａＡ、ＣＡ１９－９、ＲＮａｓｅ及ＲＮａｓｅⅠ对胰腺癌具有较好的诊断价值，敏感性为８６．７％～８０．８％；特异性８８．５％～９６．６９％。联合检测可显著提高胰腺癌的检出率，选择３～４项对胰腺癌相对特异的肿瘤标志物联合检测是胰腺癌临床诊断的重要手段之一。Pancreatic oncofetal antigen (POA),minimolecular pancreatic oncofetal antigen(mPOA),pancreatic cancer-associated antigen from normal colonic mucosa(CAAc),pancreas-specific antigen(PaA),elastase I(E I),human pancreatic elastase I(HPE I),glycylproline dipeptidyl aminopeptidase(GPDA),ribonuclease(RNase)and its isoenzymes(RNase I and RNase Ⅲ),αl-antitryypsin(α1AT),CA19-9 and CEA were determined in the serum samples of 270 normal subjects(the control),143 cases of pancreatic cancer,125 cases of hepatic or periampullar carcinoma,120 cases of gut carcinoma and 105 cases of pancreatitis to assess whether serological examinations were valuable for the diagnosis of pancreatic carcinoma.It was found that POA,mPOA;PCAAc,P3A,CA19-9.RNase andRNase I were ableto differenti.ate pancreatic carcinoma from the benign disorders of the pancreas with a sensitivity from 66.75%to 80.8%.and a specificity from 88.5%to 96.69%.The determination of 3 or 4 tumor markers combinedly would in crease the detection rate of pancreatic carcinoma,which will be an important procedure for the diagnosis of that malignancy.

关 键 词：胰腺肿瘤 血清学诊断 

分 类 号：R735.904[医药卫生—肿瘤]