胰腺癌患者血清中巨噬细胞抑制因子-1的大样本临床研究

Clinical research of serum macrophage inhibitory cytokine-1 in large samples of patients with pancreatic cancer

目的探讨巨噬细胞抑制因子1(MIC-1)在胰腺癌诊断、早期诊断及治疗监测中的临床价值。方法应用自主研制的MIC-1检测试剂盒检测552例不同临床分期的胰腺癌患者、115例胰腺良性肿瘤患者、21例慢性胰腺炎及200例健康人血清样本中MIC-1水平,并对部分早期肿瘤患者的病程进行随访监测;应用罗氏Cobas 601电化学发光免疫分析仪检测上述样品中的CEA和CA19-9水平并与MIC-1检测结果进行比较。结果胰腺癌患者组MIC-1血清水平显著高于良性肿瘤、慢性胰腺炎和正常对照组(1755.12±1112.23,863.56±508.24*,1264.35±751.09**,391.56±299.55*,*P<0.001,**P=0.040);MIC-1、CA19-9和CEA诊断胰腺癌的ROC曲线下面积依次为0.945、0.836和0.791,在特异性均为97%时,MIC-1、CA19-9和CEA诊断的敏感性分别为73.9%、61.9%和33.3%;MIC-1在早期胰腺癌患者(Ⅰ+Ⅱ期)中显示出良好的诊断敏感性(77.9%),远优于CA19-9和CEA(52.9%和27.9%);MIC-1与CA19-9联合检测,灵敏度可由原来CA19-9的61.9%提高至89.3%,显著优于MIC-1、CA19-9和CEA单独检测;早期胰腺癌患者MIC-1血清水平在手术治疗后显著下降(P<0.001),肿瘤进展时MIC-1水平又显著升高(P<0.001)。结论研究结果明确显示MIC-1是胰腺癌有价值的新血清肿瘤生物标志物,对于提高胰腺癌的诊断和早期诊断水平以及反映临床疗效具有重要的临床意义。

Objective To investigate the clinical value of macrophage inhibitory cytokine-1 （ MIC-1 ） in the diagno- sis, early diagnosis, and treatment monitoring of pancreatic cancer. Methods serum samples form 522 patients with dif- ferent clinical stages of pancreatic cancer, 115 patients with benign pancreatic tumor, 21 patients with chronic pancreatitisand 200 healthy persons were analyzed by self-made MIC-1 assay kit. And the patients at early stage were followed up. CEA and CA19-9 were analyzed by Roche Cobas 601 ECL analyzer and compared with MIC-1. Results The MIC-1 level in pancreatic cancer patients was significantly higher than that in benign tumor, chronic pancreatitis and normal control （1755.12±1112.23, 863.56±508.24＊, 1264. 35±751.09, 391.56±299.55＊＊, ＊P〈0.001,＊P=0.040）. Area under the ROC curve of MIC-1, CA19-9 and CEA in diagnosis of pancreatic eaneer was 0. 945, 0. 836 and 33. 3% , respectively. As the specificity was stayed in 97% , the sensitivity of MIC-1, CA19-9 anti CEA of the pancreatic cancer was 73.9% , 61.9% and 33.3% , respectively. MIC-1 （77.9%） was more sensitive than CA19-9 and CEA （52. 9% and 27. 9% ） in patients with early pancreatic cancer （ phase Ⅰ ＋ Ⅱ ）. Combined detection of CA19-9 and MIC-1 increased the sensitivity from 61.9% （ CA19-9 alone） to 89. 3% , which was significantly better than detection of MIC-1, CEA and CA19-9 alone. Serum levels of MIC-1 in patients with early pancreatic cancer decreased significantly after surgi- cal treatment （ P 〈 0. 001 ）, while it significantly increased after turner developed （ P 〈 0. 001 ）. Conclusion MIC-1 is a new and effective biomarker in serum for the diagnosis of pancreatic cancer. It is valuable in improving early diagnosis and monitoring clinical response.