Clinical Value Of Macrophage Inhibitory Cytokine-1and Regenerating Islet-derived Family, Member4as Serum Tumor Marker For Diagnosis Of Pancreatic Cancer

Objective：To explore the clinical value of macrophage inhibitory cytokine-1(MIC-1) and regenerating isletderived family, member4as serum tumor markerfor diagnsis of pancreatic cancer.Methods：Serum MIC-1and REG4levels were measured by enzymelinkedimmunoserbent assay (ELISA) in42patients with pancreatic cancer,30patientswith benign pancreatic disease, and30healthy control subjects. Meanwhile, theresults of MIC-1and REG4were compared with that of CA19-9. The relationshipof the serum level of MIC-1and REG4in pancreatic cancer with its clinicalpathological factors were also analyzed.Results：(1) The serum MIC-1level in patients with pancreatic cancer was(1592.56±808.59) pg/mL, which was significantly higher than that in patients withbenign pancreatic disease (400.61±104.34) pg/mL or healthy subjects(386.06±145.45pg/mL)(both P<0.01), and the REG4in patients with pancreaticcancer was also significantly higher than that in patients with benign pancreaticdisease or healthy subjects (5.06±1.45ng/mL vs3.08±0.41ng/mL vs2.55±0.38ng/mL, both P<0.01), while serum MIC-1or REG4level had no significantlydifferent between the patients with benign pancreatic disease and healthy subjects(P>0.05). But the serum level and positive rate of MIC-1or REG4in pancreaticcancer had no correlation with its tumor size, perineural invasion, regional lymphnode metastasis and TNM stage (P>0.05).(2) The sensitivity specificity, positivepredictive value, negative predictive value, Yuen’s index of MIC-1measurementfor diagnosis of pancreatic cancer were83.33%,93.33%,94.59%,80%,0.77and0.96, respectively,which were all higher than those of the corresponding values ofCA19-9(73.81%,90%,93.94%,71.05%,0.64and0.85, respectively). Thesensitivity, negative predictive value, and AUC of REG4measurement for diagnosisof pancreatic cancer were92.86%,86.96%, and0.95, respectively, which were allhigher than those of thecorresponding values of CA19-9(73.81%,71.05%and 0.85), but the specificity,positive predictive value and Yuen’s index (66.67%,79.59%and0.59) were inferior to CA19-9(90%,93.94%and0.64). The sensitivity ofcombined measurement of MIC-1or REG4and CA19-9were90.48%and97.62%,which were higher than those of single marker detection, but the specificity ofcombined measurement were lower than those of single marker detection.(3) Thepositive rate of MIC-1and REG4in patients with benign pancreatic disease were3.33%and6.67%, respectively, which were significantly lower than that of ofCA19-9(26.67%, P<0.05). The positive rate of CA19-9in patients with benignpancreatic disease complicated with jaundice was significantly higher than thatpatients without jaundice (55.56%vs14.28%, P<0.05), while whether complicatedwith jaundice or not, it had no influence on the positive rate of MIC-1and REG4(P>0.05).Conclusions：(1) Patients with pancreatic cancer has an higher serum level ofMIC-1and REG4, But the serum level and positive rate of MIC-1or REG4inpancreatic cancer had no correlation with its tumor size, perineural invasion, regionallymph node metastasis and TNM stage.(2) The comprehensive diagnostic ability ofMIC-1is better than CA19-9for diagnosis of pancreatic cancer. The sensitivity ofREG4is higher than that of CA19-9，but the specificity is lower than that ofCA19-9.(3) Serum MIC-1or REG4combine with CA19-9measurement caneffectively improve the sensitivity in diagnosis of pancreatic cancer. MIC-1andREG4may potentially be novel serum tumor marker for pancreatic cancer.