尿核苷检测在原发性胆囊癌诊断中的意义  

Urinary nucleosides in the diagnosis of primary gallbladder carcinoma

作　　者：莫宇轩[1] 彭和平[1] 陈开运[1] 汤凌佳[2] 石景森[3] 焦兴元[4] 

机构地区：[1]广州医科大学附属第二医院肝胆外科,510260 [2]广州医科大学附属第二医院神经内科,510260 [3]西安交通大学医学院第一附属医院普通外科 [4]中山大学附属第一医院器官移植科

出　　处：《中华肝胆外科杂志》2013年第11期841-845,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金面上项目（No.81071984）

摘　　要：目的探讨尿核苷检测在原发性胆囊癌诊断中的意义。方法采用反相高效液相色谱法对10种核苷标准品进行方法学验证，然后检测28例原发性胆囊癌患者、62例胆囊炎和胆囊息肉患者和70例正常人的尿中核苷水平，并与传统肿瘤标记物CA19-9和CA125相比较，探讨尿核苷与原发性胆囊癌的临床关系。结果在人尿液的核苷排放范围内，10种核苷的线性相关性良好（r〉0．99），回收率介于87．4％～121．5％，准确率介于87．7％～121．3％，精确度RSD介于1．5％～10．5％。原发性胆囊癌组10种核苷中除了c和A外，其余的8种核苷水平显著高于良性胆囊疾病组和正常对照组（P〈O．01）。通过主成分分析法，89．3％的原发性胆囊癌患者被正确识别，敏感性与传统肿瘤标记物CA19-9（60．7％），CA125（67．9％）相比，差异有统计学意义（P〈0．01）。结论尿中核苷有望成为一种新型标记物，与其他肿瘤标记物和检查手段结合，可对原发性胆囊癌的初筛和早期诊断具有重要的临床参考价值。Objective To evaluate the value of urinary normal and modified nucleosides in the diagnosis of primary gallbladder carcinoma. Methods Between March 2011 to September 2012, 28 patients with primary carcinoma of the gallbladder （PCG） were included in this study. Spontaneous u- rine samples were collected and 10 kinds of urinary nucleosides in the sample were determined by re- versed-phase high performance liquid chromatography method. Another 62 patients with benign gall- bladder disease and 70 healthy volunteers were enrolled as controls. Routine clinical tumor markers, including serum CA19-9 and CA125 levels of the PCG patients were also evaluated. Results 10 kinds of nucleoside had a good linear correlation （r〉0. 99）, and the recovery rate was between 87.4%- 121.5% range, and the accuracy rate was between 87.7%- 121.3 %, and the RSD of precision was between 1.5%-10.5% range. In addition to adenosine and cytidine, the mean levels of the rest of the urinary nucleosides in the PCG group were much higher than those of the controls （P〈0. 01）. Based on principal component analysis, 89.3~ of the PCG patients were correctly identified, which was much higher than those detected by CA19-9 （60.7%） and CA125 （67.9%） （P〈0.01）. Conclusion Urinary nucleosides may become additional tumor markers which when combined with other clinical methods may help in the screening and early diagnosis of primary gallbladder cancer.

关 键 词：胆囊肿瘤 核苷类 肿瘤标记 生物学 

分 类 号：R735.8[医药卫生—肿瘤]