Clinical diagnostic value of serum autotaxin and lysophosphatidic acid in pancreatic cancer
10.3760/cma.j.cn115667-20230605-00079
- VernacularTitle:血清溶血磷脂酶自黏蛋白和溶血磷脂酸对胰腺癌的临床诊断价值
- Author:
Hao LIN
1
;
Xiaozhong GUO
;
Hongyu LI
;
Xu LIU
;
Jiang CHEN
Author Information
1. 中国人民解放军北部战区总医院消化内科，沈阳 110840
- Keywords:
Pancreatic neoplasms;
Biomarker;
Diagnosis;
Lysophospholipids;
Autotaxin
- From:
Chinese Journal of Pancreatology
2023;23(6):437-442
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical diagnostic value of autotaxin(ATX) and its product lysophosphatidic acid(LPA) in patients with pancreatic cancer.Methods:Peripheral blood samples and related clinical data of 114 patients with pancreatic cancer (pancreatic cancer group) and 94 patients with benign pancreatic disease (benign pancreatic disease group) diagnosed in the Northern Theater General Hospital from January 2015 to May 2021 were collected, and peripheral blood of 120 healthy volunteers was used as control group. Patients′ gender, age, smoking history, history of alcohol consumption, family history of pancreatic cancer, tumor site and size, lymph node metastasis or not, peripheral nerve infiltration and the like were all recorded. Serum ATX, LPA and CA19-9 level was detected by ELISA. The receiver operating characteristic curve (ROC) of ATX alone, LPA alone and(or) combined with CA19-9 for the clinical diagnosis of pancreatic cancer was plotted, and the area under the curve (AUC) was calculated. Maximal Youden index method was used to determine the cutoff, and the sensitivity and specificity were calculated.Results:There were 54(47.3%) patients with high sugar diet and 60(52.6%) patients with smoking in pancreatic cancer group, which were higher than 15(16.1%) and 11(11.7%) in benign pancreatic disease group, and 24(20%) and 26(21.7%) in control group ( n=120). The serum ATX, LPA and CA19-9 of early and advanced pancreatic cancer [294.9(262, 1 455)ng/ml, 15.75(8.3, 92)μg/ml and 131.1(23, 289)U/ml; 422(312, 1 620)ng/ml, 24.6(9.5, 97.3)μg/ml and 217.4(32, 970)U/ml] were all greatly increased, and all the differences were statistically significant (all P value<0.05). The AUC values of serum ATX for early and advanced pancreatic cancer were 0.71 (95% CI 0.52-0.87) and 0.92 (95% CI 0.81-0.98), respectively; the Youden index was 0.57, the cutoff was 286 ng/ml, and the sensitivity was 65.3% and 89.6%, respectively; the specificity was 80%. The AUC values of LPA were 0.75 (95% CI 0.67-0.91) and 0.95 (95% CI 0.89-0.99); the Youden index was 0.48, the cutoff was 10.7 μg/ml, and the sensitivity was 80.7% and 95.7%, respectively; the specificity was 69.4%. The AUC values of CA19-9 were 0.82 (95% CI 0.71-0.85) and 0.86 (95% CI 0.78-0.93); the Youden index was 0.47, the cutoff was 57 U/ml, and the sensitivity was 77.3% and 82.3%, respectively; the specificity was 75.0%. Compared to control group and benign pancreatic disease group, the predictive efficiency of serum ATX+ CA19-9 and CA19-9+ ATX+ LPA for the diagnosis of early pancreatic cancer was significantly higher than that of CA19-9 alone, and the difference was statistically significant (all P value<0.05), while the predictive efficiency of serum ATX+ CA19-9 and CA19-9+ ATX+ LPA for the diagnosis of advanced pancreatic cancer was not significantly different from that of CA19-9 alone. Conclusions:The combined detection of serum LPA, ATX and CA19-9 can improve the diagnostic efficiency of early pancreatic cancer.
