CAJ | 학술논문

目的研究对超声内镜引导下细针穿刺活检(EUS-FNA)胰腺癌(PDA)组织进行S100A6基因mRNA表达水平检测的可行性和其对PDA的诊断价值.方法收集18份PDA患者手术切除胰腺标本及22份相对正常胰腺标本,抽提标本RNA进行逆转录,行荧光定量PCR测定S100A6基因表达水平,通过受试者工作特征曲线(ROC)分析确立S100A6 mRNA表达水平用于检测PDA的诊断界值.选取28例因胰头占位行EUS-FNA的患者,前瞻性评价EUS-FNA标本中S100A6 mRNA表达水平对PDA的术前诊断价值.通过免疫组织化学染色观察S100A6蛋白在PDA中的表达情况.结果 PDA患者EUS-FNA标本和手术标本中S100A6 mRNA表达水平(0.05023±0.10120,0.02083±0.02848)显著高于相对正常胰腺组织(0.00164±0.00202),差异有统计学意义(均P＜0.01).22例PDA患者EUS-FNA标本的S100A6表达水平显著高于6例胰腺良性疾病穿刺标本(0.00193±0.00278,P=0.0009),6例胰腺良性疾病穿刺标本与相对正常胰腺手术标本中S100A6表达水平无差异(P=0.6143).以EUS-FNA标本中S100A6 mRNA表达水平＞0.00525为阳性诊断标准,前瞻性检测PDA的敏感度、特异度、准确度分别为90.01％、100％和92.85％.结论 EUS-FNA标本中S100A6基因mRNA在PDA中高水平表达,具有良好的术前诊断价值.
목적 연구대초성내경인도하세침천자활검(EUS-FNA)이선암(PDA)조직진행S100A6기인mRNA표체수평검측적가행성화기대PDA적진단개치.방법 수집18빈PDA환자수술절제이선표본급22빈상대정상이선표본,추제표본RNA진행역전록,행형광정량PCR측정S100A6기인표체수평,통과수시자공작특정곡선(ROC)분석학립S100A6 mRNA표체수평용우검측PDA적진단계치.선취28례인이두점위행EUS-FNA적환자,전첨성평개EUS-FNA표본중S100A6 mRNA표체수평대PDA적술전진단개치.통과면역조직화학염색관찰S100A6단백재PDA중적표체정황.결과 PDA환자EUS-FNA표본화수술표본중S100A6 mRNA표체수평(0.05023±0.10120,0.02083±0.02848)현저고우상대정상이선조직(0.00164±0.00202),차이유통계학의의(균P＜0.01).22례PDA환자EUS-FNA표본적S100A6표체수평현저고우6례이선량성질병천자표본(0.00193±0.00278,P=0.0009),6례이선량성질병천자표본여상대정상이선수술표본중S100A6표체수평무차이(P=0.6143).이EUS-FNA표본중S100A6 mRNA표체수평＞0.00525위양성진단표준,전첨성검측PDA적민감도、특이도、준학도분별위90.01％、100％화92.85％.결론 EUS-FNA표본중S100A6기인mRNA재PDA중고수평표체,구유량호적술전진단개치.
Objective To investigate the feasibitity of detecting S100A6 expression at mRNA level in endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) pancreatic ductal adenocarcinoma (PDA) specimens and its diagnostic value in PDA.Methods A total of 18 PDA specimens and 22 normal pancreatic specimens were collected. RNA was extracted for reverse transcription.The expression of S100A6 gene was examined by real-time polymerase chain reaction.The cut-off value of S100A6 expression at mRNA level in PDA diagnosis was established through receiver operating characteristic (ROC) analysis. 28 patients with pancreatic head masses were selected for EUS-FNA examination,and the value of S100A6 mRNA expression level in PDA diagnosis was prospectively evaluated. The expression of S100A6 protein in PDA tissue was determined by immunohistochemistry staining.Results S100A6 mRNA expression in EUS-FNA and surgical PDA specimens (0.05023±0.10120,0.02083 ± 0.02848) was significantly higher than that of normal pancreatic tissues (0.00164±0.00202),both P＜0.01.The expression of S100A6 in 22 EUS-FNA PDA specimens was significantly higher than that of 6 pancreatic benign disease biopsy specimens (0.00193 ± 0.00278,P =0.0009). There was no significant difference in S100A6 expression between 6 pancreatic benign disease biopsy specimens and normal surgical pancreatic samples (P=0.6143).When S100A6 mRNA expression in EUS-FNA specimens over 0.00525 was taken as positive diagnostic value,the sensitivity,specificity and accuracy in prospective pancreatic cancer diagnosis were 90.01％,100 ％ and 92.85 ％,respectively.Conclusion The high expression of S100A6 mRNA in EUS-FNA specimens of PDA has good preoperative diagnostic value.