血清Kisspeptin-1在胰腺癌诊断和预后判断中的临床意义

Clinical significance of serum Kisspeptin-1 in diagnosis and prognosis prediction in pancreatic cancer

目的:探讨血清人吻素-1(kisspeptin-1,KISS-1)水平在胰腺癌诊断和预后评估中的价值。方法:回顾性分析2015年4月至2018年12月在湖北省肿瘤医院就诊的90例胰腺癌患者(胰腺癌组)的临床资料,并选取40例胰腺良性病变患者作为胰腺良性病变组以及30例健康体检者作为对照组。采用ELISA法分别检测各组血清KISS-1和CA19-9水平,分析CA19-9、KISS-1对胰腺癌的诊断效能及其与胰腺癌预后的关系。结果:胰腺癌组血清KISS-1水平明显高于胰腺良性病变组和对照组(均P<0.01);血清KISS-1、CA19-9以及联合检测的曲线下面积(AUC)分别为0.757(95%CI:0.684~0.831,P=0.000)、0.900(95%CI:0.854~0.946,P=0.000)、0.906(95%CI:0.861~0.950,P=0.000),其中两者联合检测与KISS-1检测的AUC值的差异有统计学意义(Z=3.124,P=0.024)、CA19-9与KISS-1的AUC值的差异有统计学意义(Z=3.253,P=0.025);相关分析结果显示,KISS-1与CA19-9之间呈显著负相关(r=-0.358,P=0.002)。生存曲线分析结果显示,血清KISS-1≥73.6 pg/ml患者的生存时间明显优于KISS-1<73.6 pg/ml的患者(χ~2=4.520,P=0.036);KISS-1<73.6 pg/ml与患者的预后独立相关,其OR为2.37(1.08~4.75)。结论:血清KISS-1有助于胰腺癌的早期诊断,联合检测KISS-1和CA19-9有助于提高诊断胰腺癌的敏感性、特异性,并且有助于预后评估。

Objective: To investigate the value of pre-treatment kisspeptin(KISS-1) expression for diagnosis and prognosis prediction of pancreatic cancer. Methods: The clinical data of 90 patients with pancreatic cancer(pancreatic cancer group) in Cancer Hospital of Hubei Province from April 2015 to December 2018 were retrospectively analyzed;in addition, 40 patients with benign pancreatic lesions were selected as the benign pancreatic lesion group and 30 healthy people were chosen as control group. The serum levels of KISS-1 and CA19-9 in each group were detected by ELISA. The diagnostic efficacies of CA19-9 and KISS-1 in pancreatic cancer and their relationship with the prognosis of pancreatic cancer were analyzed. Results: The serum KISS-1 level in the pancreatic cancer group was significantly higher than that in the benign pancreatic lesion group and the control group(both P<0.01);the area under the curve(AUC) of serum KISS-1, CA19-9 and their combination for pancreatic cancer detection was 0.757(95% CI: 0.684-0.831,P=0.000), 0.900(95% CI: 0.854-0.946, P=0.000), and 0.906(95% CI: 0.861-0.950, P=0.000), respectively. The AUC value of the combined detection was statistically different from that of KISS-1(Z=3.124, P=0.024), and the AUC value of CA19-9 was also statistically differently from KISS-1(Z=3.253, P=0.025). Correlation analysis showed that there was a significant negative correlation between KISS-1 and CA19-9(r=-0.358, P=0.002). The results of survival curve analysis showed that the survival time of patients with serum KISS-1≥73.6 pg/ml was significantly better than that of patients with KISS-1<73.6 pg/ml(χ~2=4.520, P=0.036);KISS-1<73.6 pg/ml was independently related to the patient’s prognosis with an OR of 2.37(1.08-4.75). Conclusion: Serum KISS-1 is helpful for the early diagnosis of pancreatic cancer, and the combined detection of KISS-1 and CAI9-9 can improve the sensitivity and specificity of pancreatic cancer diagnosis, and also is beneficial for prognosis evaluation.