血清糖链抗原、粘附分子及K-ras基因突变水平在胰腺癌中的表达及其临床意义  

Serum Carbohydrate Antigen,adhesion Molecules and K-ras Gene Mutations Levels in Pancreatic Cancer and Their Clinical Significance

作　　者：宋红林[1] 

机构地区：[1]河南省安阳市人民医院,455000

出　　处：《实用癌症杂志》2017年第7期1105-1109,共5页The Practical Journal of Cancer

摘　　要：目的探讨血清糖链抗原、粘附分子及K-ras基因突变联合检测在胰腺癌诊断中的应用价值,及其在胰腺癌中的表达意义。方法收集109例胰腺癌患者(Ⅰ期14例、Ⅱ期33例、Ⅲ期39例、Ⅳ期23例;淋巴结转移56例,无淋巴结转移53例)、78例胰腺炎患者和98例健康体检者血清。采用化学发光法检测血清CA50、CA125、CA199、CA242水平,采用双抗夹心法酶联免疫吸附试验法检测ICAM、VCAM、ALCAM、CEACAM水平,采用聚合酶链反应法检测K-ras基因突变情况。结果胰腺癌组CA50、CA125、CA199、CA242、VCAM、ALCAM、CEACAM水平和K-ras突变率明显高于胰腺炎组和健康对照组(P<0.05);胰腺炎组VCAM、ALCAM、CEACAM水平明显高于健康对照组(P<0.05),而胰腺炎组和健康对照组CA50、CA125、CA199、CA242水平和K-ras突变率比较,差异无统计学意义(P>0.05)。联合检测[logit(P)=0.114×CA199+0.235×CEACAM+0.082×K-ras]对胰腺癌的诊断价值最大,AUC达0.931,显著高于各个指标单独检测,其敏感性和特异性分别达94.5%和86.9%。VCAM、ALCAM、CEACAM水平随胰腺癌分期的增加,水平不断升高(P<0.05);有淋巴结转移的胰腺癌患者粘附分子VCAM、ALCAM、CEACAM水平均明显高于无淋巴结转移胰腺癌患者(P<0.05)。结论糖链抗原、粘附分子和K-ras基因突变联合检测能够大大提高胰腺癌的诊断效能,其中粘附分子表达水平与胰腺癌的分期和淋巴结转移密切相关。Objective To discuss the application of serum carbohydrate antigen,adhesion molecules and K-ras gene mutations levels in pancreatic cancer and their clinical significance. Methods 109 cases of pancreatic cancer patients （ I stage 14 cases, I1 stage 33 cases, HI stage 39 cases, IV stage 23 cases ;lymph node metastasis 56 cases, non-lymph node metastasis 53 ca- ses） ,78 cases of pancreatitis patients and 98 cases of healthy controls were collected. Serum CA50, CA125, CA199, CA242 levels were detected by chemiluminescence method, ICAM, VCAM, ALCAM and CEACAM levels were detected by double-antibody sandwich enzyme-linked immunosorbent assay method, and K-ras gene mutation was detected by polymerase chain reaction meth- od. Results Levels of CAS0,CA125,CA199,CA242,VCAM,ALCAM,CEACAM and K-ras mutation in pancreatic cancer were significantly higher than those of pancreatitis group and healthy control group （ P 〈 0.05 ）. Levels of VCAM, ALCAM, and CEACAM in pancreatitis group were significantly higher than those of healthy control group （P 〈 0.05 ）. There were no significant difference in CA50, CA125, CA199, CA242 levels and K-ras mutation rates between pancreatitis group and healthy control group （ P 〉 0.05 ）. Combination test [ logit（P） = 0.114 x CA199 ＋ 0.235 x CEACAM ＋ 0. 082 x K-ras ] had the most diagnostic value for pancreatic cancer, with AUC of 0. 931, which was significantly higher than individual indicators tested, and the sensitivity and specificity were 94.5% and 86.9%. Levels of VCAM, ALCAM, CEACAM were increased with stage enhancing of pancreatic cancer（P 〈 0.05） ;Levels of VCAM,ALCAM, and CEACAM in lymph node metastasis group were significantly higher than those of non-lymph node metastasis group （P 〈 0.05 ）. Conclusion Serum carbohydrate antigen, adhesion molecules and K-ras gene mutations combination detection can greatly improve the diagnostic efficacy of pancreatic cancer, and the expression of adhesion molecules is closely related to the stage and lymph node

关 键 词：糖链抗原 粘附分子 K-RAS基因突变 胰腺癌 分期 

分 类 号：R735.9[医药卫生—肿瘤]