超声内镜引导下细针穿刺活检组织中S100A6mRNA水平对胰腺癌的诊断价值  

Diagnostic value of S100A6 mRNA expression level in endoscopic uitrasonography guided fine needle aspiration specimens in pancreatic cancer

作　　者：张杰[1] 郭子皓[1] 梁燕[1] 李雪[1] 陈婧[1] 张景[1] 朱静[1] 高茹[1] 周卫真[1] 郝建宇[1] 

机构地区：[1]首都医科大学附属北京朝阳医院消化科,100020

出　　处：《中华消化杂志》2012年第5期320-324,共5页Chinese Journal of Digestion

基　　金：吴阶平医学基金临床科研专项（320.6750.09.161）;首都医学发展科研基金（2009-2072）

摘　　要：目的研究对超声内镜引导下细针穿刺活检（EUS-FNA）胰腺癌（PDA）组织进行S100A6基因mRNA表达水平检测的可行性和其对PDA的诊断价值。方法收集18份PDA患者手术切除胰腺标本及22份相对正常胰腺标本，抽提标本RNA进行逆转录，行荧光定量PCR测定S100A6基因表达水平，通过受试者工作特征曲线（ROC）分析确立S100A6mRNA表达水平用于检测PDA的诊断界值。选取28例因胰头占位行EUS—FNA的患者，前瞻性评价EUS—FNA标本中S100A6mRNA表达水平对PDA的术前诊断价值。通过免疫组织化学染色观察S100A6蛋白在PDA中的表达情况。结果PDA患者EUS—FNA标本和手术标本中S100A6mRNA表达水平（O．05023±0．10120，0．02083±0．02848）显著高于相对正常胰腺组织（0．00164±0．00202），差异有统计学意义（均P〈O．01）。22例PDA患者EUS-FNA标本的S100A6表达水平显著高于6例胰腺良性疾病穿刺标本（0．00193±0．00278，P=0．0009），6例胰腺良性疾病穿刺标本与相对正常胰腺手术标本中S100A6表达水平无差异（P=0．6143）。以EUS-FNA标本中S100A6mRNA表达水平〉0．00525为阳性诊断标准，前瞻性检测PDA的敏感度、特异度、准确度分别为90．01％、100％和92．85％。结论EUSFNA标本中S100A6基因mRNA在PDA中高水平表达，具有良好的术前诊断价值。Objective To investigate the feasibitity of detecting S100A6 expression at mRNA level in endoscopic ultrasonography guided fine needle aspiration （EUS-FNA） pancreatic ductal adenocarcinoma （PDA） specimens and its diagnostic value in PDA. Methods A total of 18 PDA specimens and 22 normal pancreatic specimens were collected. RNA was extracted for reverse transcription. The expression of S100A6 gene was examined by real-time polymerase chain reaction. The cut-off value of S100A6 expression at mRNA level in PDA diagnosis was established through receiver operating characteristic （ROC） analysis. 28 patients with pancreatic head masses were selected for EUS-FNA examination, and the value of S100A6 mRNA expression level in PDA diagnosis was prospectively evaluated. The expression of S100A6 protein in PDA tissue was determined by imnmnohistochemistry staining. Results S100A6 mRNA expression in EUS-FNA and surgical PDA specimens （0.05023±0. 10120, 0.02083±0.02848） was significantly higher than that of normal pancreatic tissues （0.00164±0.00202）, both P〈0. 01. The expression of S100A6 in 22 EUS-FNA PDA specimens was significantly higher than that of 6 pancreatic benign disease biopsy specimens （ 0. 00193 ±0. 00278. P = 0. 0009 ）. There was no significant difference in S100A6 expression between 6 pancreatic benign disease biopsy specimens and normal surgical pancreatic samples （P=0.6143）. When S100A6 mRNA expression in EUS-FNA specimens over 0. 00525 was taken as positive diagnostic value, the sensitivity, specificity and accuracy in prospective pancreatic cancer diagnosis were 90.01%,100 % and 92.85 %, respectively. Conclusion The high expression of S100A6 mRNA in EUS-FNA specimens of PDA has good preoperative diagnostic value.

关 键 词：胰腺肿瘤 S100蛋白质类 RNA 信使 腔内超声检查 活组织检查 细针 聚合酶链反应 基因表达 

分 类 号：R735.9[医药卫生—肿瘤]