胰腺癌患者血清膜联蛋白A2 水平及与临床病理特征和预后的关系

Serum annexin A2 level in patients with pancreatic cancer and its relationship with clinicopathological characteristics and prognosis

摘要:

目的 研究胰腺癌患者血清膜联蛋白A2 （ANXA2） 水平，探讨其在胰腺癌中的临床意义。方法 选取2016年7月—2017年12月在浙江省台州医院就诊的胰腺癌患者90例作为胰腺癌组，同期该院健康体检者 90 例作为对照组。采用双抗夹心酶联免疫吸附试验测定血清ANXA2和糖类抗原19-9 （CA19-9） 水平。结果 胰腺癌组血清ANXA2、CA19-9水平高于对照组（P <0.05）。不同年龄、性别、饮酒史、吸烟史、肿瘤部位、肿 瘤大小、临床分期、肿瘤分化程度、神经浸润的胰腺癌患者血清ANXA2水平比较，差异无统计学意义（P > 0.05）；有远处转移和有淋巴结转移患者血清ANXA2水平高于无远处转移和无淋巴结转移者（P <0.05）。血清 ANXA2、CA19-9诊断胰腺癌的ROC曲线下面积（AUC）分别为0.826和0.871，敏感性分别为76.67%（95% CI： 0.764，0.771） 和83.33% （95% CI：0.829，0.836），特异性分别为78.89% （95% CI：0.786，0.792） 和85.56% （95% CI：0.853，0.859）；两者联合诊断胰腺癌的AUC为0.924，敏感性为91.11% （95% CI：0.908，0.914），特 异性为92.22%（95% CI：0.918，0.926）。ANXA2低表达组的2年总生存期比率和无病生存期比率均高于ANXA2 高表达组（P <0.05）。结论 胰腺癌患者血清ANXA2水平升高，血清ANXA2联合CA19-9对胰腺癌的诊断效能 更好，在评估病情程度和预后中具有一定价值。

Abstract:

Objective To study the level of serum annexin A2 (ANXA2) in patients with pancreatic cancer, and to explore its clinical significance. Methods Ninety patients with pancreatic cancer from July 2016 to December 2017 in Taizhou Hospital of Zhejiang Province were selected as the pancreatic cancer group, and 90 healthy individuals undergoing physical examination during the same period were selected as the control group. The serum levels of ANXA2 and carbohydrate antigen 19-9 (CA19-9) were measured by double-antibody sandwich enzyme-linked immunosorbent assay. Results The levels of serum ANXA2 and CA19-9 in the pancreatic cancer group were higher than those in the control group (P < 0.05). There was no statistically significant difference in serum ANXA2 levels of pancreatic cancer patients that differ in age, gender, history of alcohol consumption, smoking history, tumor location, tumor size, clinical stage, tumor differentiation and nerve invasion (P > 0.05). The serum ANXA2 levels in patients with distant metastasis and lymph node metastasis were higher than those without distant metastasis and lymph node metastasis (P < 0.05). The area under the receiver operating characteristic (ROC) curve for the diagnosis of pancreatic cancer by serum ANXA2 and CA19-9 were 0.826 and 0.871 respectively, with the sensitivity being 76.67% (95% CI: 0.764, 0.771) and 83.33% (95% CI: 0.829, 0.836) and the specificity being 78.89% (95% CI: 0.786, 0.792) and 85.56% (95% CI: 0.853, 0.859). The area under the ROC curve for the diagnosis of pancreatic cancer by the combination of ANXA2 and CA19-9 was 0.924, and the sensitivity and specificity were 91.11% (95% CI: 0.908, 0.914) and 92.22% (95% CI: 0.918, 0.926), respectively. The 2-year overall survival (OS) rate and disease-free survival (DFS) rate of the group with low expression of ANXA2 were higher than those of the group with high expression of ANXA2 (P < 0.05). Conclusions The level of serum ANXA2 in patient with pancreatic cancer is elevated. The level of serum ANXA2 is conducive to improving the diagnostic efficacy of CA19- 9 in pancreatic cancer, and has a potential value in assessing the severity of disease and prognosis.