Cathepsin E expression in pancreatic cancer

组织蛋白酶E（CTSE）是一种非分泌型的细胞内天冬氨酸蛋白酶，存在于胃的浅表上皮细胞中，在胰腺导管细胞癌中也有表达。通过与CA 19 -9、CEA、K-ras基因突变及细胞学检查的比较，评价了CTSE对胰腺癌的诊断价值。对111例患者的胰液进行了检查，其中29例为胰腺导管细胞癌，82例为慢性胰腺炎。胰泌素刺激10 min后收集ERCP期间的胰液，收集的胰液的一半用于细胞学检查。取上清液和超浓缩沉淀物进行CTSE、CA 19 -9、CEA和K-ras基因突变分析。导管癌CTSE阳性率为63%，CA 19 -9阳性率为33%，CEA阳性率为17%，K-ras突变阳性率为41%，细胞学阳性率为69%。慢性胰腺炎CTSE阳性率为8%，CA 19 -9阳性率为10%，CEA阳性率为1%，K-ms突变阳性率为17%，细胞学阳性率为0%。导管细胞癌患者的胰液CTSE检出率明显高于慢性胰腺炎患者和细胞学检查。CTSE与细胞学检查联合诊断胰腺导管细胞癌的准确率为92%，是目前诊断胰腺导管细胞癌最高的联合诊断方法。

It has been reported that cathepsin E (CTSE) is a non-secretory and intracellular aspartic proteinase found in the superficial epithelial cells of the stomach, and is also expressed in ductal cell carcinoma of the pancreas. We evaluated the diagnostic value of CTSE in pancreatic juice in comparison with those of CA19-9, CEA, K-ras mutation and cytology. Pancreatic juice was examined in 111 patients ; 29 with ductal cell carcinoma of the pancreas and 82 with chronic pancreatitis. Pancreatic juice was collected during ERCP after secretin stimulation for 10 min. Half amount of the collected juice was applied to cytology. The supernatant and sediment ultracentrifuged from the remaining juice were applied to the analysis of CTSE, CA19-9, CEA, and K-ras mutation. In patients with ductal cell carcinoma the positive rates of CTSE was 63%, that of CA19-9 was 33%, that of CEA was 17%, that of K-ras mutation was 41% and that of cytology was 69%. In patients with chronic pancreatitis the positive rate of CTSE was 8%, that of CA19-9 was 10%, that of CEA was 1%, that of K-ms mutation was 17% and that of cytology was 0%. The detection frequency of CTSE in pancreatic juice was significantly higher in patients with ductal cell carcinoma than in patients with chronic pancreatitis as well as cytology. The accuracy of the combination of CTSE and cytology in detecting ductal cell carcinoma of the pancreas was 92%, it is the highest of various combinations of these diagnostic marker for the definitive diagnosis of ductal cell carcinoma of the pancreas.