血清CA19-9与粪便K-ras、p53突变在胰腺癌诊断中的价值  

A study on the diagnosis of serum CA19-9,fecal K-ras and p53 gene muta-tion in pancreatic cancers

作　　者：胡海燕[1] 刘颂[1] 苑凤昌[1] 葛杰[1] 林宇[1] 高庆林[1] 

机构地区：[1]齐齐哈尔医学院第一附属医院,黑龙江齐齐哈尔161041

出　　处：《中国医药导报》2009年第35期151-153,共3页China Medical Herald

基　　金：黑龙江省教育厅科学技术研究资助项目(项目编号:11521326)

摘　　要：目的:评价血清肿瘤标志物CA19-9和粪便K-ras以及p53基因突变对早期胰腺癌的诊断价值。方法:收集2006年9月～2009年3月在我院确诊的新发胰腺癌患者56例,胰腺良性疾病患者90例,进行血清肿瘤标志物CA19-9和粪便K-ras以及p53基因突变的检测,根据血清CA19-9的水平及粪便K-ras、p53基因突变率,进行临床分析。结果:血清CA19-9水平、粪便K-ras、p53突变率3项早期及中晚期胰腺癌组与胰腺良性疾病患者组比较,均有显著性差异(P<0.05);早期与中晚期胰腺癌组比较,均无显著性差异(P>0.05)。CA19-9检测(>37KU/L为阳性)诊断胰腺癌的敏感性为80.4%(45/56),特异性为73.3%(66/90)。粪便K-ras对胰腺癌诊断的敏感性为87.5%(49/56),特异性为50.0%(45/90)。粪便p53对胰腺癌诊断的敏感性为82.1%(46/56),特异性为70.0%(63/90)。结论:早期胰腺癌组血清CA19-9水平有81.8%的病例升高,粪便K-ras以及p53基因突变率分别为81.8%、77.3%,血清CA19-9水平对早期胰腺癌有较高的诊断价值,联合粪便K-ras以及p53基因突变的检测,可以显著提高早期胰腺癌的诊断效率。Objective： To evaluate the diagnostic value of serum tumor marker CA19-9, fecal K-ras and p53 gene mutation in pristine pancreatic cancers. Methods： We collected 56 new cases of pancreatic cancers and 90 patients with benign disease of pancreas diagnosed in our hospital from September 2006 to March 2009. Serum tumor marker CA19-9, fecal K-ras and p53 gene mutation were measured. We made clinical analysis according to the level of serum CA19-9, fecal K-ras and p53 gene mutation rate. Results： The serum CA19-9 level, fecal K-ras, the rate of p53 geue mutation in early and ad- vanced pancreatic cancer group had significantly different compare to benign pancreatic disease group （P〈0.05）, in the early pancreatic cancer group and advanced pancreatic cancer group had not significantly different （P〉0.05）. The sensitivity of CA19-9 detection （〉37 KU/L was positive） for the diagnosis of pancreatic cancers was 80.4% （45/56）, the specificity was 73.3% （66/90）. The sensitivity of fecal K-ras on pancreatic cancers diagnosis was 87.5% （49/56）, the specificity was 50.0% （45/90）. The sensitivity of P53 fecal on diagnosis of pancreatic cancers was 82.1% （46/56）, the specificity was 70.0% （63/ 90）. Conclusion： The level of serum CA19-9 in 81.8% cases heightens in the pristine pancreatic cancers group, fecal K- ras and p53 gene mutation rate are 81.8% and 77.3%. The level of serum CA19-9 has higher diagnostic value in pristine pancreatic cancer. Combined detection of fecal K-ras and p53 gene mutation, it significantly elevated diagnostic efficiency of pristine pancreatic cancer.

关 键 词：胰腺癌 肿瘤标志物 基因K—ras 基因P53 突变 

分 类 号：R73[医药卫生—肿瘤]