胰腺细针穿刺标本中粘蛋白MUC1、MUC5AC的临床意义

目的检测胰腺细针穿刺标本中粘蛋白MUC1、MUC5AC的临床意义。方法对54例胰腺占位病变的EUS-FNA活检标本采用SP免疫组化法检测粘蛋白MUC1、MUC5AC表达,根据临床综合判断的诊断,与细胞学和组织学检查结果比较,评价其诊断价值。结果54例患者最后确诊为胰腺癌38例,胰腺良性肿瘤6例,慢性胰腺炎10例。细胞学和组织学的诊断敏感性分别为31.6%和47.4%。MUC1、MUC5AC、MUC1 MUC5AC在胰腺癌EUS-FNA标本组织中的阳性表达率为81.6%、84.2%和76.3%,显著高于胰腺良性疾病的25%、43.8%和6.3%的表达(P<0.01)。细胞学和组织学检查结合MUC1和MUC5AC的检测诊断胰腺癌的敏感性可提高到84.2%,特异性达100%。结论检测胰腺FNA标本中粘蛋白MUC1、MUC5AC的表达有助于提高对胰腺癌的诊断。

Diagnostic value of MUC1 and UCSAC expression profile in specimens of pancreas fine needle aspiration.

Objective To investigate MUC1 and MUC5AC expression in specimens of pancreas fine-needle aspiration and evaluate the diagnostic value.Methods The expression level of MUC1 and MUC5AC was examined by immunohistochemical SP method with MUC1 and MUC5AC monoclonal antibody in 54 EUS-FNA samples of pancreatic occupying lesions.The results were compared with the cytohistologic diagnosis according to the final clinical general diagnosis as standard for pancreatic cancer.Results Of the 54 cases,38 were ultimately diagnosed as pancreatic cancer,6 as benign tumor,and 10 as chronic pancraetitis.The sensitivity of cytology and histology in diagnosis of pancreatic cancer was 31.6% and 47.4%,respectively.The positive rate of MUC1,MUC5AC and MUC1 MUC5AC was 81.6%,84.2% and 76.3%,respectively in EUS-FNA samples of pancreatic cancer,versus 25%,43.8% and 6.3% in benign pancreatic neoplasms.The difference was statistically significant.The sensitivity of combined detection of MUC1 and MUC5AC expression and cytohistologic analysis in EUS-FNA specimens was 89.5% in diagnosis of pancreatic cancer.Conclusions Detection of MUC1 and MUC5AC expression in EUS-FNA specimens from pancreatic neoplasms could assist in the diagnosis of pancreatic cancer.