胰腺癌组织DKK-1的检测及临床意义探讨

目的：探讨胰腺占位性病变患者Dickkopf-1（DKK-1）的表达及对胰腺癌的诊断及鉴别诊断价值。方法：收集63例胰腺占位性病变患者的石蜡切片,采用免疫组织化学法对DKK-1在胰腺癌组织及胰腺炎等组织中的表达情况进行检测,全自动标记免疫发光分析仪检测血CA19-9,分析DKK-1与患者临床病理特征及CA19-9的关系。结果：胰腺癌组织中DKK-1阳性率68.2%,明显高于胰腺良性病变组织中的DKK-1阳性率5.3%（P〈0.01）；DKK-1的表达在胰腺癌的分化程度和TNM分期间差异均有统计学意义（P〈0.05）；单一DKK-1阳性率68.2%,单一血CA19-9阳性率为65.9%,联合检测有一项阳性表达计为阳性,阳性率为88.6%,差异均有统计学意义（P〈0.01）；DKK-1＋CA19-9联合诊断胰腺癌均较DKK-1和CA19-9单一诊断的灵敏度、约登指数及符合率增高。结论：DKK-1在胰腺癌组织表达明显高于胰腺良性病变组织,在胰腺肿瘤的形成、发展中起到一定作用,DKK-1的检测有助于胰腺癌的诊断、预后评估。

Detection of Dkk-1 in pancreatic carcinoma and its clinical significance

Objective：To detect the expression of the Dickkopf-1（DKK-1） in pancreas space-occupying lesions and its value in the diagnosis and differential diagnosis of pancreatic cancer. Methods：Sixty-three paraffin specimens of pancreas space-occupying lesions were collected,the expressions of DKK-1 in pancreatic cancer tissue and pancreatitis tissue were detected using immunohistochemical method. The blood CA19-9 level was measured by automatic labeling immunoluminescence analyzer. The relationships between DKK-1 and clinically pathological characteristics of patients and blood CA19-9 were analyzed. Results：The positive expression rate of DKK-1 in pancreatic cancer tissue（68. 2%） was significantly higher than that in benign pancreatic lesions（5. 3%）（P〈0. 01）. The differences of DKK-1 expression in various differentiation degrees and TNM stages had statistical significance（P 〈0. 05）. The positive rate of DKK-1 and blood CA19-9 were 68. 2% and 65. 9%,respectively,the positive rate of the joint detection was 88. 6%,the difference of which had statistical significance（P〈0. 01）. Compared with the single DKK-1 and CA19-9 detection,the diagnosis sensitivity,Youden index and coincidence rate of the joint detection of DKK-1 and CA19-9 in the diagnosis of pancreatic cancer were high. Conclusions：The expression of DKK-1 in pancreatic cancer tissue is significantly higher than that in benign pancreatic lesion, which plays an important role in the formation and growth of pancreatic tumor. The detection of DKK-1 is helpful to the diagnosis and prognosis assessment of pancreatic cancer.