河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (1): 35-38.doi: 10.3969/j.issn.1007-3205.2022.01.008

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GPC-1外泌体、CD82外泌体和CA19-9用于胰腺癌诊断的病例对照研究

  

  1. 1.河北省人民医院肝胆外科，河北 石家庄 050051；2.河北北方学院研究生学院，河北 张家口 075000；3.河北医科大学
    研究生学院，河北 石家庄 050017；4.邯郸钢铁集团有限责任公司职工医院外科，河北 邯郸 056001
  • 出版日期:2022-01-25 发布日期:2022-01-24
  • 作者简介:郭怀斌(1974-)，男，河北邯郸人，河北省人民医院主任医师，副教授，医学博士研究生，从事肝胆外科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题计划（20180005）

A case-control study of GPC-1 exosomes, CD82 exosomes and CA19-9 in the diagnosis of pancreatic cancer

  1. 1.Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang 050051, China; 
    2.Graduate School， Hebei North College，Hebei Province, Zhangjiakou 075000, China; 
    3.Graduate School， Hebei Medical University， Shijiazhuang 050017, China; 
    4.Department of Surgery, Staff Hospital of Handan Iron and Steel Group 
    Limited Company， Hebei Province, Handan 056001, China
  • Online:2022-01-25 Published:2022-01-24

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摘要： 目的  研究磷脂酰肌醇蛋白聚糖1（glypican-1，GPC-1）外泌体、分化抗原（cluster of differentiation，CD）82外泌体和CA19-9对胰腺癌（pancreatic ductal adenocarcinoma，PDAC）的诊断价值。
方法  选择PDAC患者（PDAC组）31例和慢性胰腺炎患者（CP组）22例，抽取清晨空腹外周血，分离外泌体，采用免疫组织化学SP法染色，流式细胞仪测定GPC-1外泌体和CD82外泌体的比率，采用电化学发光免疫分析法测定CA19-9含量。 
结果  PDAC组CA19-9、GPC-1外泌体表达水平高于CP组，差异有统计学意义（P＜0.05）。2组CD82外泌体表达水平差异无统计学意义（P＞0.05）。CA19-9、GPC-1外泌体、CA19-9与GPC-1外泌体联合诊断PDAC的曲线下面积为0.771、0.918、0.922，GPC-1外泌体对PDAC的诊断价值优于CA19-9(P＜0.05)。CA19-9与GPC-1〖JP2〗外泌体联合诊断PDAC优于CA19-9独立诊断，差异有统计学意义(P＜0.05)；CA19-9与GPC-1外泌体联合诊断PDAC与GPC-1〖JP〗外泌体独立诊断差异无统计学意义(P＞0.05)。PDAC患者外周血CA19-9与GPC-1外泌体无相关（r=0.237，P=0.200）。
结论  检测GPC-1外泌体对PDAC的诊断价值优于CA19-9；GPC-1外泌体联合CA19-9可提高PDAC诊断的特异度，降低误诊率。


关键词: 胰腺肿瘤, 肿瘤标记物, 诊断

Abstract: Objective  To study the value of glypican-1(GPC-1)exosomes, cluster of differentiation(CD) 82 exosomes and CA19-9 in the diagnosis of pancreatic duct adenocarcinoma(PDAC). 
Methods  In total, 31 PDAC patients(PDAC group) and 22 chronic pancreatitis(CP) patients(CP group) were selected. Fasting peripheral blood was collected in the early morning, and exosomes were isolated and stained with immunohistochemistry SP method.The ratio of GPC-1 exosomes to CD82 exosomes was determined by flow cytometry, and the content of CA19-9 was determined by electrochemiluminescence immunoassay. 
Results  The expression of CA19-9 and GPC-1 exosomes in PDAC group was higher than that of CP group, and the difference was statistically significant(P＜0.05). No significant difference was found in the expression of CD82 exosomes in the two groups(P＞0.05). The area under ROC curve(AUC) of CA19-9, GPC-1 and the combination of CA19-9 and GPC-1 exosomes in the diagnosis was 0.771, 0.918 and 0.922 respectively; the diagnostic value of GPC-1 exosomes was superior to CA19-9 in PDAC, and the difference was statistically significant(P＜0.05). The diagnostic value of combination of plasma CA19-9 and GPC-1 exosomes was superior to CA19-9 alone in PDAC,and the difference was statistically significant(P＜0.05); but the diagnostic value of combination of plasma CA19-9 and GPC-1 exosomes was not superior to GPC-1 exosomes alone in PDAC, and the difference was no statistically significant(P＞0.05). And there was no correlation between CA19-9 in peripheral blood and GPC-1 exosomes in PDAC(r=0.237, P=0.200). 
Conclusion  The diagnostic value of plasma GPC-1 exosomes in PDAC is superior to that of CA19-9, and combination of the two indicators can improve sensitivity and reduce the misdiagnosis rate.


Key words: pancreatic neoplasms, tumor marker, diagnosis

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