血清循环核小体、乳酸及丙酮酸检测在胰腺肿瘤辅助诊断中的价值及临床意义  

Value and clinical significance of detecting serum circulating nucleosomes,lactate,and pyruvate in the auxiliary diagnosis of pancreatic tumors

作　　者：王一然 艾子译 阿卜莱海提·图尔贡 王玥 刘旭骏 司文喆 WANG Yiran;AI Ziyi;ABULAIHAITI·Tuergong;WANG Yue;LIU Xujun;SI Wenzhe(Department of Clinical Laboratory,Peking University Third Hospital,Beijing 100191,China;Department of Clinical Laboratory,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第三医院检验科,北京100191 [2]北京大学第一医院检验科,北京100034

出　　处：《国际检验医学杂志》2024年第21期2572-2576,共5页International Journal of Laboratory Medicine

基　　金：国家自然科学基金面上资助项目(82303063);北京市科技新星计划项目(20220484090);科技新星交叉合作项目(20230484442);北京市自然科学基金项目(7232206);北京市卫健委优促计划赋能基金项目(YC202301QX0087)。

摘　　要：目的通过检测胰腺导管腺癌患者、胰腺其他肿瘤患者和健康者血清中循环核小体、乳酸和丙酮酸的水平,探讨表观遗传修饰因子与代谢产物对于胰腺癌的早期诊断和鉴别诊断的临床意义。方法选取北京大学第三医院2022年1月至2023年4月收治的26例胰腺导管腺癌患者作为实验组,胰腺其他肿瘤组包括胰腺实性假乳头状瘤8例,胰腺浆液性囊腺瘤11例和胰腺神经内分泌瘤9例,选择同期门诊体检的26例健康者作为健康对照组。采用酶联免疫吸附试验与靶向代谢组学的方法分别检测血清中循环核小体和乳酸、丙酮酸的表达水平。采用SPSS26.0统计软件进行多变量统计分析,比较实验组、胰腺其他肿瘤组和健康对照组血清中的表达差异是否有统计学意义,并通过生物信息学分析公共数据库中不同分期的胰腺癌患者的代谢组学结果。结果实验组与健康对照组血清相比较,乳酸(P<0.001)、丙酮酸(P<0.001)、循环核小体(P<0.001)的表达水平差异有统计学意义,提示3种标志物对诊断胰腺导管腺癌有较高的灵敏度和特异度;此外,3种标志物在实验组血清中的表达水平显著高于在其他胰腺肿瘤组血清的表达水平,提示可以用于区分不同种类的胰腺肿瘤;在胰腺其他肿瘤组的血清表达水平显著高于健康对照组,有望成为新的胰腺肿瘤风险指标;其中丙酮酸在联合模型里差异最显著。生物信息学分析提示在不同分期的胰腺癌患者中,丙酮酸与乳酸均为差异代谢物。结论循环核小体、乳酸和丙酮酸在3组之间有较高的灵敏度和特异度,可以作为胰腺癌的新标志物方向。Objective To explore the clinical significance of epigenetic modification factors and metabolites in the early diagnosis and differential diagnosis of pancreatic cancer by detecting the levels of circulating nucleosomes,lactic acid and pyruvate in the serum of patients with pancreatic ductal adenocarcinoma,patients with other pancreatic tumors and healthy people.Methods A total of 26 patients with pancreatic ductal adenocarcinoma admitted to Peking University Third Hospital from January 2022 to April 2023 were selected as the experimental group.The other pancreatic tumor group included 8 cases of solid pseudopapillary tumor of the pancreas,11 cases of serous cystadenoma of the pancreas,and 9 cases of neuroendocrine tumor of the pancreas.Another 26 healthy individuals who underwent outpatient examinations during the same period were selected as the health control group.Enzyme linked immunosorbent assay and targeted metabolomics were used to detect the expression levels of circulating nucleosomes,lactate,and pyruvate in serum,respectively.SPSS26.0 statistical software was used for multivariable statistical analysis to compare whether the difference in serum expression in the experimental group,other pancreatic tumor group and the health control group was statistically significant,and the metabonomics results of pancreatic cancer patients at different stages in the public database were analyzed by bioinformatics.Results There were statistically significant differences in the expression levels of lactate(P<0.001),pyruvate(P<0.001),and circulating nucleosomes(P<0.001)between the experimental group and the health control group,suggesting that the three had high sensitivity and specificity for the diagnosis of pancreatic ductal adenocarcinoma.Moreover,the expression levels of the three in the serum of the experimental group were significantly higher than those in the serum of other pancreatic tumor group,suggesting that these could be used to distinguish the types of pancreatic tumors.The serum expression levels of the

关 键 词：胰腺癌 循环核小体 乳酸 丙酮酸 辅助诊断 

分 类 号：R735.9[医药卫生—肿瘤]