THE STUDY ON SOLUBLE FORM OF HLA CLASS I MOLECULE AS A NEW CANDIDATE OF TUMOR MARKER IN PANCREATIC CANCER.

背景资料：在最近的研究中，已经在血液、尿液、腹水和各种其他组织中发现了可溶性形式的人类白细胞抗原（HLA）I类（sHLA-I）。研究集中在sHLA-I在器官移植免疫耐受诱导中的作用。为了研究sHLA-I在恶性肿瘤患者免疫系统中的作用，我们检测了胰腺、胆道和肝脏恶性肿瘤及其他疾病患者的血清sHLA-I水平。材料与方法：应用酶联免疫吸附试验（ELISA）检测了胰腺癌（n = 19）、良性胆道疾病和慢性胰腺炎（n = 20）、肝细胞癌（n = 51）、胆囊癌（n = 6）和胆管细胞癌（n = 6）患者血清中sHLA-Ⅰ水平，并与正常对照组（n = 22）进行了比较。在胰腺癌患者中，我们还分析了sHLA-I与CA 19 -9的关系，以及sHLA-I的特异性和敏感性。当排除急性或慢性肝炎患者后，胰腺癌患者的平均sHLA-I水平显著高于正常对照组良性病变组（P <0.01）、肝细胞癌组（P <0.01）、胆囊癌组（P <0.05）、胆管癌组（P < 0.05）。我们确定了正常对照的血清sHLA-I临界值为2000 ng/ml ; 10例胰腺癌患者的血清sHLA-I水平高于临界值，14例患者中有9例的血清CA 19 -9水平低于37 IU/l。敏感性和特异性分别为88.2%和85.5%。讨论内容：虽然我们发现胰腺癌细胞系不产生sHLA-I，但胰腺癌患者血清sHLA-I水平高于其他疾病。血清sHLA-I水平的评估在胰腺癌中可能具有临床意义。

Background : In recent studies a soluble form of human leukocyte antigen (HLA) class I (sHLA-I) has been found in blood, urine, ascitic fluid and various other tissues. Research has been focused on the role of sHLA-I in the induction of immunotolerance in organ transplantation. To examine the role of sHLA-I in the immune system of patients with malignancy, we examined serum sHLA-I levels in patients with pancreatic, biliary and hepatic malignancy and other diseases. Materials and methods : We examined sHLA-I levels in the sera of patients with pancreatic cancer (n = 19), benign biliary disease and chronic pancreatitis (n = 20), hepatocellular carcinoma (n = 51 ), gallbladder cancer (n = 6) and cholangiocellular carcinoma (n = 6), as well as in normal controls (n = 22), using enzyme-linked immunosorbent assay (ELISA). In patients with pancreatic cancer we also analyzed the relationship between sHLA-I and CA19-9, and the specificity and sensitivity of sHLA-I.Results : When patients with acute or chronic hepatitis were excluded from analysis, the mean sHLA-I level in patients with pancreatic cancer was significantly higher than that of normal controls (P < 0.01) and patients with benign disease (P < 0.01), hepatocellular carcinoma (P < 0.01), gallbladder cancer (P < 0.05) and cholangiocarcinoma (P < 0.05). We determined a serum sHLA-I cut-off level for normal controls of 2000 ng/ml ; serum levels of sHLA-I were higher than the cut-off in 10 patients with pancreatic cancer, and serum levels of CA19-9 were lower than 37 IU/l in 9 out of 14 patients. The sensitivity and specificity were 88.2% and 85.5%, respectively. Discussion : Serum levels of sHLA-I in pancreatic cancer were higher than in the other diseases, although we found that pancreatic cancer-cell lines did not produce the sHLA-I.The evaluation of serum sHLA-I levels could have clinical significance in pancreatic cancer.