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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 factor-1 (MIC-1) in the diagnosis, early diagnosis and treatment of pancreatic cancer. Methods The MIC-1 levels of 552 pancreatic cancer patients with different clinical stages, 115 patients with benign pancreatic tumors, 21 chronic pancreatitis and 200 healthy volunteers were detected by MIC-1 kit. Early cancer patients were monitored for follow-up. The CEA and CA19-9 levels in these samples were determined by Roche Cobas 601 electrochemiluminescence immunoassay and compared with MIC-1. Results The serum levels of MIC-1 in patients with pancreatic cancer were significantly higher than those in benign tumors, chronic pancreatitis and normal controls (1755.12 ± 1112.23, 863.56 ± 508.24 *, 1264.35 ± 751.09 **, 391.56 ± 299.55 *, * P <0.001, * * P = 0.040). The area under the ROC curves of MIC-1, CA19-9 and CEA for the diagnosis of pancreatic cancer were 0.945,0.836 and 0.791, respectively, and MIC-1, CA19-9 and CEA were all diagnosed when the specificity was 97% Were 73.9%, 61.9% and 33.3%, respectively; MIC-1 showed good diagnostic sensitivity (77.9%) in patients with early stage pancreatic cancer (stage I + II), far superior to those of CA19-9 and CEA 52.9% and 27.9%, respectively). The sensitivity of MIC-1 and CA19-9 was significantly improved from 61.9% of CA19-9 to 89.3%, which was significantly better than that of MIC-1, CA19-9 and CEA alone. MIC-1 serum levels decreased significantly after surgery (P <0.001), and MIC-1 levels were significantly increased (P <0.001) as tumors progressed. Conclusions The results clearly show that MIC-1 is a valuable biomarker of serum tumor in pancreatic cancer. It has important clinical significance for improving the diagnosis and early diagnosis of pancreatic cancer and reflecting clinical efficacy.