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目的探讨联合检测患者外周血K-ras基因突变和血清CA19-9对胰腺癌的诊断作用。方法采用高分辨率熔解曲线(HRM)法和电化学发光免疫分析法,分别检测胰腺癌患者(25例)、胰腺非癌性患者(15例)和正常对照组(15例)外周血中,K-ras基因突变和CA19-9水平,并对结果进行统计学分析。结果胰腺癌患者外周血中,K-ras基因突变率为48.0%,胰腺非癌性病变组突变率为6.7%;CA19-9在胰腺癌组中阳性率为72.0%,胰腺非癌性病变中阳性率为13.0%。K-ras基因突变与CA19-9平行法联合检测(即两项指标中有一项为阳性即为阳性)诊断胰腺癌的敏感度和特异度分别为80.0%和80.0%。采用系列法联合检测(两项指标必须均为阳性)诊断胰腺癌的敏感度和特异度分别为40.0%和100%。15例健康对照者外周血中K-ras基因和CA19-9均无异常。结论联合检测外周血K-ras基因突变和CA19-9可以为胰腺癌的诊断提供一种敏感性、特异性高的无创性检测方法。
Objective To explore the combined detection of K-ras gene mutations in peripheral blood and serum CA19-9 in the diagnosis of pancreatic cancer. Methods High-resolution melting curve (HRM) and electrochemiluminescence immunoassay were used to detect the expression of IL-6 in peripheral blood of patients with pancreatic cancer (25 cases), non-cancerous pancreas (15 cases) and normal control group (15 cases) K-ras gene mutations and CA19-9 levels, and the results were statistically analyzed. Results The mutation rate of K-ras gene was 48.0% in peripheral blood of pancreatic cancer patients and 6.7% in non-cancerous pancreatic tissues. The positive rate of CA19-9 in pancreatic cancer was 72.0%, and in pancreatic non-cancerous lesions The positive rate was 13.0%. The sensitivity and specificity of K-ras mutation detection in combination with CA19-9 parallel method (positive for one of the two indicators) were 80.0% and 80.0%, respectively. The sensitivity and specificity for the diagnosis of pancreatic cancer using a series of combined tests (both indicators must be positive) were 40.0% and 100%, respectively. There were no abnormalities of K-ras gene and CA19-9 in peripheral blood of 15 healthy controls. Conclusions Combined detection of K-ras gene mutation and CA19-9 in peripheral blood can provide a sensitive and specific noninvasive detection method for the diagnosis of pancreatic cancer.