血清ULBP-2、MIC-1联合检测诊断胰腺癌的价值

Diagnostic value of combined measurement of serum ULBP-2 and MIC-1 for pancreatic cancer

目的探讨UL16结合蛋白2（ULBP-2）、巨噬细胞抑制因子-1（MIC-1）联合检测对胰腺癌诊断的价值。方法收集152例胰腺癌、20例胰腺癌前病变、91例慢性胰腺炎患者及96例健康对照者血清，应用酶联免疫吸附测定（ELISA）方法检测ULBP-2、MIC-1水平，并和CA19-9水平进行比较。采用受试者工作特征（ROC）曲线评估它们对胰腺癌的诊断价值。结果胰腺癌、胰腺癌前病变、慢性胰腺炎及健康对照者血清ULBP-2水平分别为（219．9±182．5）、（62．6±11．4）、（68．4±36．8）、（76．5±40．9）μg／L；MIC-1水平分别为（3521．3±3903．4）、（973．6±589．0）、（959．6±879．0）、（427．6±317．0）μg／L；CA19-9水平分别为（1448．8±3707．0）、（12．0±9．3）、（38．2±139．0）、（7．7±5．0）kU／L。胰腺癌患者均显著高于癌前病变、慢性胰腺炎患者及健康对照者（X^2值分别为40．628、71．662、45．505，15．827、36．433、63．494，26．264、73．427、49．088，P值均〈0．01）。ULBP-2、MIC-1、CA19-9诊断胰腺癌的曲线下面积（AUC）分别为0．909、0．818、0．864，三者联合诊断的AUC为0．982，单指标诊断以ULBP-2为佳，三者联合诊断效能最高。对胰腺癌早期病变（胰腺癌前病变＋胰腺癌IA期病变）的诊断，ULBP-2、MIC-1、CA19-9的AUC分别为0．506、0．837、0．684，单指标以MIC-1为佳，而MIC-1联合CA19—9的诊断效能最高（AUC为0．897）。结论ULBP-2、MIC-1在胰腺癌患者血清中含量升高，二者联合CA19-9检测可提高对胰腺癌的诊断价值。

Objective To investigate the diagnostic value of UL-16 binding protein 2 （ULBP-2）, macrophage inhibitory cytokine-1 （MIC-1） for pancreatic cancer. Methods The serum samples of 152 pancreatic cancer patients, 20 precursors of pancreatic cancer, 91 chronic pancreatitis patients and 96 age/sex- matched healthy persons were collected. The serum ULBP-2 and MIC-1 levels were determined by using the ELISA kit and were compared with level of CA19-9. A receiver operating characteristic （ROC） curve was constructed to evaluate their diagnostic values for pancreatic cancer. Results The serum levels of ULBP-2 in patients with pancreatic cancer, precursors of pancreatic cancer, chronic pancreatitis and healthy persons were （219.9 ± 182.5 ）, （62.6 ± 11.4）, （68.4 ± 36.8 ）, （76.5 ± 40.9 ） μg/L, the corresponding values of MIC 1 were （3521.3± 3903.4）, （973.6± 589.0）, （959.6± 879.0）, （427.6± 317.0） μg/L, while the corresponding values of CA19-9 were （ 1448.8 ± 3707.0） , （ 12.0 ± 9.3 ） , （ 38.2 ± 139.0 ） , （ 7.7 ± 5.0 ） kU/L. The parameters in pancreatic cancer patients were significantly higher than those in control group （ X^2 =40. 628,71. 662,45. 505,15. 827,36. 433,63. 494,26. 264,73. 427,49. 088, P 〈 0. O1 ）. The area under ROC curves（AUC） of ULBP-2, MIC-1, CA19-9 were 0. 909, 0.864, 0. 818, and ULBP-2 was superior to CA19-9 and MIC-1, however the combined measurement of three markers produced the highest diagnostic yield（ AUC = 0.982）. For early stage pancreatic diseases （precursors to pancreatic cancer and IA stage pancreatic cancer）, AUC of ULBP-2, MIC-1, CA19-9 were O. 506,0.837,0.684, MIC-1 was superior to ULBP-2 and CA19-9, however the combined measurement of MIC-1 and CA19-9 produced the highest diagnostic yield（ AUC = 0.897）. Conclusions Serum ULBP-2, MIC-1 levels are significantly elevated in pancreatic cancer patients. The combined measurement of ULBP-2, MIC-1 and CA 19-9 can increase the diagnostic yield for pancreatic cancer.