sICAM-1、sVCAM-1和P选择素检测对胰腺癌诊断和预后评估的价值  

Diagnostic and prognosis assessment values of serum sICAM-1,sVCAM-1 and P-selectin detection for the patients with pancreatic carcinoma

作　　者：朱伟[1] 黄文[1] 武新颖[1] 徐纪平[1] 蔡全才[1] 李兆申[1] 

机构地区：[1]第二军医大学长海医院消化病研究所,上海200433

出　　处：《解放军医学杂志》2009年第1期10-12,共3页Medical Journal of Chinese People's Liberation Army

基　　金：国家科技支撑计划课题(2006BAI02A12);上海市自然科学基金资助项目(06ZR14013)

摘　　要：目的探讨血清可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管内皮细胞黏附因-1(sVCAM-1)和P选择素检测对胰腺癌诊断和预后评估的临床价值。方法2007年10月-2008年6月收治的胰腺癌患者70例,包括胰头癌45例,胰体、胰尾癌25例;TNM分期Ⅰ-Ⅱ期34例,Ⅲ-Ⅳ期36例。采用酶联免疫法(ELISA)法测定患者手术前后血清sICAM-1、sVCAM-1和P选择素水平,并与30例胰腺良性病变患者进行比较。结果胰腺癌患者血清sICAM-1、sVCAM-1和P选择素水平明显高于胰腺良性病变患者(P<0.01);Ⅲ-Ⅳ期胰腺癌患者血清sICAM-1、sVCAM-1和P选择素水平明显高于I-Ⅱ期患者(P<0.05)。sICAM-1、sVCAM-1和P选择素检测的敏感度分别为81.4%、85.7%、84.3%,三者联合检测的敏感度为92.9%。行根治性手术组(39例)术后血清sI-CAM-1、sVCAM-1和P选择素水平均较术前显著降低(P<0.05),而姑息性手术组(31例)则无明显变化(P>0.05)。结论血清sI-CAM-1、sVCAM-1和P选择素水平是胰腺癌诊断和预后判断的敏感性指标,三者联合应用可提高胰腺癌早期诊断的敏感性。Objective To investigate the diagnostic and prognosis assessment values of serum soluble intercellular adhesion molecule-1 （sICAM 1）, soluble vascular cell adhesion molecule-1 （sVCAM-1） and P-selectin for the patients with pancreatic carcinoma. Methods The serum levels of sICAM-1, sVCAM-1 and P-selectin of 70 patients with pancreatic carcinoma were measured by ELISA before and after operation （including pancreatic head carcinoma 45cases, body-tail pancreatic carcinoma 25cases; pancreatic carcinoma TNM stageⅠ-Ⅱ34 cases, stage Ⅲ-Ⅳ 36 cases）. Patients with benign pancreatic disease were also detected as controls. Results In the patients with pancreatic carcinoma, the serum levels of sICAM-1, sVCAM-1 and P-selectin before operation were higher than those of the benign disease controls （P〈0. 01）. The serum levels of sICAM-1, sVCAM-1 and P-seleetin in patients in stage Ⅲ-Ⅳ were significantly higher than those in stage Ⅰ-Ⅱ （P〈0. 05）. The sensitivity of sICAM-1, sVCAM-1 and P-selectin was 81.4%, 85.7% and 84. 3%, respectively. The sensitivity of combined detection of these three markers was 92. 9 %. The levels of sICAM-1, sVCAM-1 and P selectin significantly decreased in 39 cases of patients with pancreatic carcinoma after radical resection compared with those before operation （P〈0. 05）. No significant changes occurred in serum levels of sICAM-1, sVCAM-1 and P-selectin in 31 cases of patients with pancreatic carcinoma after palliative operation （P〉0.05）. Conclusions Serum levels of sICAM-1, sVCAM-1 and P-selectin are sensitive markers for diagnosis and prognosis assessment for patients with pancreatic carcinoma. The sensitivity of these three markers in the early diagnosis of pancreatic carcinoma would elevate remarkably when combined applying.

关 键 词：胰腺肿瘤 胞间黏附分子1 血管细胞黏附分子-1 P选择素 

分 类 号：R735.9[医药卫生—肿瘤]