[摘要] 目的：探讨血清细胞间黏附分子-1（intercellular adhesion molecule-1，ICAM-1）在胰腺癌诊断和预后评估中的价值。方法：选取2015 年4 月至2017 年12 月在湖北省肿瘤医院肝胆胰外科就诊的胰腺癌患者80 例（胰腺癌组）、胰腺良性疾病患者40例（良性疾病组）及同期健康体检者30 例（对照组）。分别检测3 组人群血清ICAM-1 和CA19-9 水平；采用受试者工作特征曲线（ROC）分析ICAM-1 对胰腺癌的诊断特性，采用COX回归模型分析血清ICAM-1 与胰腺癌患者预后是否独立相关。结果：胰腺癌组ICAM-1 和CA19-9 水平明显高于良性疾病组和对照组（均P<0.01），良性疾病组CA19-9 水平明显高于对照组（P<0.01）。血清ICAM-1、CA19-9 以及两者联合的曲线下面积（AUC）为0.732（95%CI：0.658~0.807，P=0.000）、0.691（95%CI:0.620~0.762, P=0.000）、0.747（95%CI ：0.674~0.821，P=0.000）；ICAM-1与CA19-9之间呈显著正相关（r=0.472，P=0.000）。血清ICAM-1<2 308 U/ml患者的生存时间明显长于≥2 308 U/ml 的患者（χ2=28.357，P=0.000）；ICAM-17≥2 308 U/ml 是患者预后的独立影响因子，其OR为3.08（2.14~7.23）。结论：血清ICAM-1 有助于胰腺癌的早期诊断和预后评估。

[Abstract] Objective: To investigate the value of intercellular adhesion molecule 1 (ICAM-1) for the diagnosis and prognosis of pancreatic cancer. Methods: Eighty patients with pancreatic cancer (pancreatic cancer group), forty patients with benign pancreatic disease (benign disease group) who were admitted to Department of Hepatobiliary and Pancreatic Surgery in Cancer Hospital of Hubei Province from April 2015 to December 2017 were included in the study; and thirty healthy subjects during the same period were included as control. Serum ICAM-1 and carbohydrate antigen 19-9 (CA19-9) levels were determined in all the three groups. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic characteristics of ICAM-1 for pancreatic cancer. The COX regression model was used to analyze whether serum ICAM-1 was independently associated with the prognosis of patients with pancreatic cancer.Results: The levels of ICAM-1 and CA19-9 in pancreatic cancer group were significantly higher than those in benign disease group and control group (P<0.01). The level of CA19-9 in benign disease group was significantly higher than that in control group (P<0.01). ROC curve analysis showed that the area under the curve (AUC) of serum ICAM-1, CA19-9 and the combinations of both was 0.732 (95% CI: 0.658-0.807, P=0.000), 0.691 (95% CI: 0.620-0.762, P=0.000), and 0.747 (95% CI: 0.674-0.821, P=0.000), respectively. There was a significant positive correlation between ICAM-1 and CA19-9 (r=0.472, P=0.000). The survival time of patients with serum ICAM-1<2 308 U/ml was significantly longer than that of patients with ICAM-1≥2 308 U/ml (χ2=28.357,P=0.000); COX regression analysis showed that ICAM-1 ≥2 308 U/ml was an independent influence factor for prognosis, with an OR of 3.08 (2.14-7.23). Conclusion: Serum ICAM-1 contributes to the early diagnosis and prognosis evaluation of pancreatic cancer.

湖北省自然科学基金资助项目(No. 2017CFC827)