血浆甲基化透明质酸酶-2检测对胰腺癌的诊断效能

Diagnostic efficacy of plasma methylated hyaluronidase-2 detection in pancreatic cancer

目的探讨血浆甲基化透明质酸酶-2(HYAL2)水平对胰腺癌的诊断效能。方法 125例疑似胰腺癌患者,根据术后病理结果分为胰腺癌64例(观察组)、胰腺良性疾病患者61例(对照组)。两组均抽取空腹肘静脉血5 m L,采用Methy Light定量PCR方法检测两组外周血甲基化HYAL2(甲基化百分比参数PMR表示),采用化学发光免疫分析法检测两组外周血CA19-9、CEA。采用Logistic回归分析胰腺癌的影响因素,分析血浆CA19-9、CEA与血浆甲基化HYAL2水平的相关性,绘制受试者工作特征曲线评价各指标对胰腺癌的诊断效能。结果观察组、对照组甲基化HYAL2检出率分别为20.3%(13/64)、3.3%(2/61),二者比较,P<0.05。观察组、对照组血浆甲基化HYAL2的PMR分别为26.12%±10.11%、46.54%±18.86%,,二者比较,P<0.05。观察组、对照组血浆CEA分别为(23.02±11.96)、(13.17±7.84)ng/m L,二者比较,P<0.05;观察组、对照组血浆CA19-9分别为(215.39±38.05)、(26.40±20.31)U/m L,二者比较,P<0.05。血浆CA19-9、CEA及甲基化HYAL2水平是胰腺癌的影响因素。胰腺癌患者血浆甲基化HYAL2水平与血浆CEA、CA19-9均呈负相关(r=-0.755,-0.512;P均<0.05)。血浆甲基化HYAL2水平诊断胰腺癌的AUC为0.804,最佳诊断点34.435%,其敏感度为73.8%,特异度为85.3%;血浆CEA诊断胰腺癌的AUC为0.597,最佳诊断点为16.97 ng/m L,其敏感度为51.6%,特异性为68.9%;血浆CA19-9诊断胰腺癌的AUC为0.775,最佳诊断点为162.49 U/m L,其敏感度为75.0%,特异性为79.2%。血浆甲基化HYAL2与血浆CA19-9联合诊断胰腺癌的AUC为0.873。结论胰腺癌患者血浆甲基化HYAL2发生率较高。血浆甲基化HYAL2诊断胰腺癌的灵敏度、特异度均较高。血浆甲基化HYAL2联合CA199检测有助于胰腺癌的诊断。

Objective To investigate the diagnostic efficacy of detecting plasma methylated hyaluronidase-2（HYAL2） levels in pancreatic cancer. Methods One hundred and twenty-five suspected pancreatic cancer patients were divided into 64 cases of pancreatic cancer（observation group） and 61 cases of benign pancreatic disease（control group）according to postoperative pathological results. The empty abdominal vein blood（5 m L） were collected from patients of the two groups,and the Methy Light quantitative PCR method was used to detect the methylation HYAL2 of peripheral blood（percentage of methylation parameter PMR）,and the chemiluminescence immunoassay was used to detect CA19-9 and CEA in the peripheral blood of the two groups. Logistic regression analysis was applied to analyze the influencing factors of pancreatic cancer. The correlation between plasma CA19-9,CEA and plasma methylation HYAL2 levels was analyzed. The receiver operating characteristic curve was drawn to evaluate the diagnostic efficacy of each index for pancreatic cancer. Results The detection rates of methylated HYAL2 in the observation group and the control group were 20. 3%（13/64） and3. 3%（2/61）,respectively,and the difference between the two groups was statistically significant（P〈0. 05）. The PMRs of plasma methylation HYAL2 in the observation group and the control group were 26. 12% ± 10. 11% and 46. 54%± 18. 86%,respectively,and the difference between the two groups was statistically significant（P〈0. 05）. The plasma CEA in the observation group and control group were（23. 02 ± 11. 96） and（13. 17 ± 7. 84） ng/m L,respectively,and the difference between the two groups was statistically significant（P〈0. 05）. The plasma CA19-9 levels in the observation group and control group were（215. 39 ± 38. 05）,（26. 40 ± 20. 31） U/m L,respectively,and the difference between the two groups was statistically significant（P〈0. 05）. Plasma CA19-9,CEA,and methylated HYAL2 levels were the influencing factors for pancreatic cancer. Plasma methylation of HYAL2 was negatively correlated with plasma CEA and CA19-9 in patients with pancreatic cancer（r =-0. 755,-0. 512; both P〈0. 05）. The AUC of the plasma methylation HYAL2 was0. 804,and the best diagnosis point was 34. 435% with the sensitivity of 73. 8% and the specificity of 85. 3%. The AUC of plasma CEA in the diagnosis of pancreatic cancer was 0. 597,and the best diagnostic point was 16. 97 ng/m L,with the sensitivity of 51. 6% and the specificity of 68. 9%. The AUC of plasma CA19-9 in the diagnosis of pancreatic cancer was0. 775. The best diagnostic point was 162. 49 U/m L. The sensitivity was 75. 0% and the specificity was 79. 2%. The AUC of plasma methylation of HYAL2 combined with plasma CA19-9 in the diagnosis of pancreatic cancer was 0. 873. Conclusions The incidence of plasma methylation of HYAL2 is high in patients with pancreatic cancer. The sensitivity and specificity of plasma methylation HYAL2 in the diagnosis of pancreatic cancer are high. Detection of plasma methylation HYAL2 combined with CA199 is helpful in the diagnosis of pancreatic cancer.