目的：探讨血清人吻素-1（kisspeptin-1，KISS-1）水平在胰腺癌诊断和预后评估中的价值。方法：回顾性分析2015 年4 月至2018 年12 月在湖北省肿瘤医院就诊的90 例胰腺癌患者（胰腺癌组）的临床资料，并选取40 例胰腺良性病变患者作为胰腺良性病变组以及30 例健康体检者作为对照组。采用ELISA法分别检测各组血清KISS-1 和CA19-9 水平，分析CA19-9、KISS-1 对胰腺癌的诊断效能及其与胰腺癌预后的关系。结果：胰腺癌组血清KISS-1 水平明显高于胰腺良性病变组和对照组（均P<0.01）；血清KISS-1、CA19-9 以及联合检测的曲线下面积（AUC）分别为0.757（95% CI：0.684~0.831，P=0.000）、0.900（95% CI：0.854~0.946，P=0.000）、0.906（95%CI：0.861~0.950，P=0.000），其中两者联合检测与KISS-1 检测的AUC 值的差异有统计学意义（Z=3.124，P=0.024）、CA19-9 与KISS-1 的AUC 值的差异有统计学意义（Z=3.253，P=0.025）；相关分析结果显示，KISS-1 与CA19-9 之间呈显著负相关（r=-0.358，P=0.002）。生存曲线分析结果显示，血清KISS-1≥73.6 pg/ml 患者的生存时间明显优于KISS-1<73.6 pg/ml 的患者（χ2=4.520，P=0.036）；KISS-1<73.6 pg/ml 与患者的预后独立相关，其OR为2.37（1.08~4.75）。结论：血清KISS-1 有助于胰腺癌的早期诊断，联合检测KISS-1 和CA19-9 有助于提高诊断胰腺癌的敏感性、特异性，并且有助于预后评估。

Objective: To investigate the value of pre-treatment kisspeptin (KISS-1) expression for diagnosis and prognosis prediction of pancreatic cancer. Methods: The clinical data of 90 patients with pancreatic cancer (pancreatic cancer group) in Cancer Hospital of Hubei Province from April 2015 to December 2018 were retrospectively analyzed; in addition, 40 patients with benign pancreatic lesions were selected as the benign pancreatic lesion group and 30 healthy people were chosen as control group. The serum levels of KISS-1 and CA19-9 in each group were detected by ELISA. The diagnostic efficacies of CA19-9 and KISS-1 in pancreatic cancer and their relationship with the prognosis of pancreatic cancer were analyzed. Results: The serum KISS-1 level in the pancreatic cancer group was significantly higher than that in the benign pancreatic lesion group and the control group (both P<0.01); the area under the curve (AUC) of serum KISS-1, CA19-9 and their combination for pancreatic cancer detection was 0.757 (95% CI: 0.684-0.831,P=0.000), 0.900 (95% CI: 0.854-0.946, P=0.000), and 0.906 (95% CI: 0.861-0.950, P=0.000), respectively. The AUC value of the combined detection was statistically different from that of KISS-1 (Z=3.124, P=0.024), and the AUC value of CA19-9 was also statistically differently from KISS-1 (Z=3.253, P=0.025). Correlation analysis showed that there was a significant negative correlation between KISS-1 and CA19-9 (r=-0.358, P=0.002). The results of survival curve analysis showed that the survival time of patients with serum KISS-1≥73.6 pg/ml was significantly better than that of patients with KISS-1<73.6 pg/ml ( χ 2=4.520, P=0.036);KISS-1<73.6 pg/ml was independently related to the patient's prognosis with an OR of 2.37 (1.08-4.75). Conclusion: Serum KISS-1 is helpful for the early diagnosis of pancreatic cancer, and the combined detection of KISS-1 and CAI9-9 can improve the sensitivity and specificity of pancreatic cancer diagnosis, and also is beneficial for prognosis evaluation.

湖北省自然科学基金资助项目（No. 2017CFC827）