血清KL－6水平在胰腺癌诊断与鉴别诊断中的价值

Diagnostic and differential value of elevated serum KL-6 levels in pancreatic cancer

目的检测胰腺癌患者血清KL-6水平，探讨其临床诊断价值。方法收集随访资料完整的53例胰腺癌（PC）、68例慢性胰腺炎（CP）、51例高危人群（high risk person，HR）的血清样本，以50例健康体检者作为对照。用ELISA方法检测血清CA50、MUC4、KL-6水平，放免法测定血清CAl9-9水平。分析它们诊断胰腺癌的敏感性、特异性及与临床病理参数、患者预后的关系。结果Pc组、cP组、HR组及对照组的血清KL-6水平分别为（753±548）、（135±93）、（105±55）及（99±50）U／m1，PC组显著高于其他3组（P〈0．01）。以〉232U／ml为界，KL-6诊断胰腺癌的敏感性为96％，特异性为94％；以〉244U／ml为界，鉴别诊断PC与CP的敏感性为97％，特异性为91％。KL-6诊断胰腺癌的临床价值高于CAl9-9、CA50及MUC4。胰腺癌患者血清KL-6水平与肿瘤的临床病理参数均无相关性。血清KL-6≤300U／ml患者的平均生存期为（9．3±1．2）个月，较KL-6〉300U／ml患者平均生存期（4．6±0．7）个月显著延长（P=0．006）。结论KL-6可作为诊断胰腺癌的血清学指标，且对胰腺癌和慢性胰腺炎的鉴别诊断有一定意义。

Objective To determine the serum KL-6 level in patients with pancreatic carcinoma and investigate its diagnostic value. Methods The data of 53 pancreatic carcinoma （PC） patients ; 68 chronic pancreatitis （CP） patients and 51 patients with high risks of pancreatic cancer （HR） with complete follow-up data were studied, and 50 healthy volunteers were used as controls. ELISA was used to measure the serum levels of KL-6, MUC4, and CAS0. Radioimmunoassay methods were used to measure the serum CA19-9 levels. The sensitivity and specificity of KL-6 for the diagnosis of PC were determined, and the relationship between its levels and clinicopathologic parameters, patients＇ outcome were analyzed. Results The serum KL-6 levels were （753 ±548）, （135 ±93）, （105±55） and （99 ±50） U/ml in PC group, CP group, HR group and control group, and the value in PC group was significantly higher than those in other 3 groups （P 〈 0.01 ）. Using 〉 232 U/ml as the cut-off point, the sensitivity and specificity of KLs6 for the diagnosis of PC was 96% and 94%. Using 〉 244 U/ml as the cut-off point, the sensitivity and specificity of KL-6 for the diagnosis of PC was 97% and 91%. The clinical value of KL-6 was higher than those of CA19-9, CAS0 and MUC4. The serum level of KL-6 was not associated with clinicopathologic parameters. The median survival of patients with serum level of KL-6 ≤300 U/ml was （9.3 ± 1.2） months, which was significantly longer than that in patients with serum level of KL-6 〉300 U/ml[（4.6 ±0.7） months, P =0.006]. Conclusions KL-6 might be a useful serological marker of pancreatic cancer, and it may play a role in the differential diagnosis between pancreatic cancer and chronic pancreatitis.