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目的检测粘蛋白(MUC1、MUC2、MUC5AC)在胰腺超声内镜细针穿刺(EUS-FNA)组织标本中的表达,评价其对胰腺癌辅助诊断的价值。方法收集54例胰腺占位病变的EUS-FNA组织标本。采用S-P免疫组化法检测粘蛋白(MUC1、MUC2、MUC5AC)的表达,根据临床综合判断的诊断.与细胞学检查结果比较,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、MUC2、MUC5AC在胰腺痛EUS-FNA标本组织中的阳性表达率为81.6%(31/38)、10.5%(4/38)、84.2%(32/38),在胰腺良性疾病组织标本中分别25%(4/16)、31.3%(5/16)、43.8%(7/16),其中MUC1和MUC5AC两组间差异有统计学意义(P<0.01)。MUC1的表达与胰腺癌的临床分期、淋巴结转移呈正相关。将细胞组织学检查结合MUC1和MUC5AC表达检测诊断胰腺癌的敏感性可提高至89.5%。结论胰腺EUS-FNA组织标本中MUC1、MUC5AC的检测对胰腺癌有临床辅助诊断价值,且MUC1还能预测胰腺癌的临床分期及淋巴结转移。
Objective To detect the expression of mucin (MUC1, MUC2, MUC5AC) in pancreatic ultrasound endoscopic fine needle aspiration (EUS-FNA) tissue and evaluate its value in the diagnosis of pancreatic cancer. Methods EUS-FNA tissue samples from 54 patients with pancreatic mass lesions were collected. The expression of mucin (MUC1, MUC2, MUC5AC) was detected by S-P immunohistochemistry, and the diagnosis was based on clinical judgment. The diagnostic value was compared with cytology results. Results The final diagnosis of 54 cases of pancreatic cancer in 38 cases, 6 cases of benign pancreatic cancer, chronic pancreatitis in 10 cases. The cytological and histological diagnostic sensitivities were 31.6% and 47.4%, respectively. The positive rates of MUC1, MUC2 and MUC5AC in pancreatic pain EUS-FNA specimens were 81.6% (31/38), 10.5% (4/38) and 84.2% (32/38), respectively. They were 25% (4/16), 31.3% (5/16) and 43.8% (7/16) respectively. There was significant difference between MUC1 and MUC5AC (P <0.01). MUC1 expression and pancreatic cancer clinical stage, lymph node metastasis was positively correlated. The sensitivity of cell histological examination combined with MUC1 and MUC5AC expression detection to detect pancreatic cancer can be increased to 89.5%. Conclusion The detection of MUC1 and MUC5AC in pancreatic EUS-FNA tissue samples has clinical value in the diagnosis of pancreatic cancer, and MUC1 can predict the clinical stage and lymph node metastasis of pancreatic cancer.