目的：检测胰腺癌患者血浆溶血磷脂酸（lysphosphaticlic acid，LPA）的水平，评价LPA在胰腺癌诊治中的临床意义。方法：采用定磷法检测2006年6月至2010年10月南京第一医院收治的胰腺癌患者50例、胰腺良性疾病患者32例及健康志愿者36人的血浆LPA水平，同时测定血清CA19-9、AFP和CEA的水平；免疫组化法检测胰腺癌组织及癌旁胰腺组织LPA2受体的表达。分析血浆LPA水平与胰腺癌临床病理特征的关系。结果：胰腺癌患者血浆LPA水平明显高于胰腺良性疾病患者和健康志愿者\[(4.10±2.03) vs (3.28±1.26)、(2.27±1.02) μmol/L，P<0.05\]，胰腺癌患者血浆LPA水平和血清CA19-9水平密切相关（r=0.9070，P＜0.01）。 胰腺癌组织LPA2受体表达阳性率显著高于癌旁正常胰腺组织（88% vs 4%，P＜0.05)。血浆LPA水平的升高与胰腺癌浸润和淋巴结转移等相关。结论：血浆LPA检测为胰腺癌诊断和预后判断增加了一项潜在的评价指标。

Objective:To observe the levels of plasma lysophosphatidic acid (LPA) in patients with pancreatic carcinoma, and to evaluate its clinical potential of diagnosis. Methods: Plasma LPA and serum CA19-9, AFP and CEA levels were measured in 50 patients with pancreatic carcinoma and 32 patients with benign pancreatic lesions hospitalized in Nanjing First Hospital during June of 2006 and October of 2010, and 36 healthy donors by phosphate determination method. Immunohistochemistry (IHC) was used to determine the expression of LPA2 receptor both in surgically resected pancreatic carcinomas and adjacent non tumor tissues. The correlation between LPA levels with clinical pathological features of pancreatic carcinoma patients was analyzed. Results: Plasma LPA concentration was significantly higher in pancreatic carcinoma patients than in patients with benign lesions and controls (\[4.10±2.03\] vs \[328±1.26\], \[2.27±1.02\] μmol/L, P＜0.05). Plasma LPA concentration was correlated with serum CA19-9 level (r=0.9070, P＜0.01) in patients with pancreatic carcinoma. The positive rate of LPA2 receptor in pancreatic carcinoma tissues was significantly higher than that in adjacent non tumor tissues (88% vs 4%, P＜0.05). Higher plasma LPA level showed a significant correlation with invasion and metastasis of pancreatic carcinoma. Conclusion: Plasma LPA level might be a potential indicator of the diagnosis and prognosis of pancreatic carcinoma.

江苏省卫生厅科教兴卫工程专项基金资助（苏卫科教2011字第15号）；南京市医学重点科技发展项目(No. ZKX09007)