糖类抗原19-9、糖类抗原50和糖类抗原242联合检测对可手术胰腺癌的临床诊断价值  

Clinical diagnostic value of combined detection of carbohydrate antigen 19-9, carbohydrate antigen 50 and carbohydrate antigen 242 in operative pancreatic cancer

作　　者：窦荣汉 周国明 张彬[1,2,3] 叶柳青[1,2,3] DOU Rong-han;ZHOU Guo-ming;ZHANG Bin;YE Liu-qing(Institute of Oncology and Basic Medicine,Chinese Academy of Sciences,Zhejiang Province,Hangzhou310022,China;Department of Clinical Laboratory,Cancer Hospital Affiliated to University of Chinese Academy of Sciences,Zhejiang Province,Hangzhou310022,China;Department of Clinical Laboratory,Zhejiang Tumor Hospital,Hangzhou310022,China)

机构地区：[1]中国科学院肿瘤与基础医学研究所,浙江杭州310022 [2]中国科学院大学附属肿瘤医院检验科,浙江杭州310022 [3]浙江省肿瘤医院检验科,浙江杭州310022

出　　处：《中国当代医药》2019年第32期12-15,19,共5页China Modern Medicine

摘　　要：目的应用Logistic回归和受试者工作特征(ROC)曲线分析糖类抗原19-9(CA19-9)、糖类抗原50(CA50)和糖类抗原242(CA242)在Ⅰ~Ⅲ期可手术胰腺癌中的临床诊断价值。方法回顾性分析2016年1月~2018年12月在浙江省肿瘤医院住院并接受过规范手术治疗的246例胰腺癌患者的临床资料作为胰腺癌组,另选取同期接受手术的128例胰腺良性肿瘤患者作为对照组。采用化学发光免疫分析(CLIA)法检测患者血清中的CA19-9、CA50和CA242的表达水平;比较两组患者血清中的CA19-9、CA50和CA242的表达水平;比较胰腺癌组中不同肿瘤(TNM)分期患者血清中的CA19-9、CA50和CA242水平;采用Logistic回归和ROC曲线计算并比较各指标单项检测及联合检测时的ROC-曲线下面积(AUC)、灵敏度、特异性及准确率。结果胰腺癌组血清中的CA19-9、CA50和CA242水平高于对照组,差异均有统计学意义(P<0.05)。在246例可切除胰腺癌中,随着胰腺癌肿瘤(TNM)分期的增加,血清CA19-9、CA50和CA242水平逐渐升高,差异均有统计学意义(P<0.05)。Logistic回归模型为Logit(P)=-0.877+0.031Y CA19-9+0.007Y CA50-0.034Y CA242。三项联合检测的AUC、灵敏度、准确率高于CA19-9、CA50和CA242单项检测,特异性低于CA19-9、CA50和CA242单项检测,差异均有统计学意义(P<0.05)。结论血清CA19-9、CA50和CA242联合检测有助于可切除胰腺癌的临床诊断和病情评估,值得临床推广应用。Objective To use the Logistic regression and receiver operating characteristic(ROC)curves to analyze saccharide antigens 19-9(CA19-9),carbohydrate antigen 50(CA50)and carbohydrate antigen 242(CA242)in stageⅠ-Ⅲoperable pancreatic cancer clinical diagnostic value.Methods The clinical data of 246 patients with pancreatic cancer who were hospitalized in Zhejiang Cancer Hospital from January 2016 to December 2018 and received standard surgical treatment were analyzed retrospectively as the pancreatic cancer group,and 128 patients with pancreatic benign tumor who received surgery at the same time were selected as the control group.The levels of CA19-9,CA50 and CA242 in serum of patients were detected by chemiluminescent immunoassay(CLIA).The expression levels of CA19-9,CA50 and CA242 in serum of the two groups were compared.The serum CA19-9,CA50 and CA242 levels of patients with different TNM stages in pancreatic cancer group were compared.The area under curve(AUC)of ROC,sensitivity,specificity and accuracy were calculated by Logistic regression and ROC curve.Results The levels of CA19-9,CA50 and CA242 in serum of pancreatic cancer group were higher than those of control group,the differences were statistically significant(P<0.05).In 246 cases of resectable pancreatic cancer,the levels of CA19-9,CA50 and CA242 increased with the increase of TNM stage,the differences were statistically significant(P<0.05).The regression model was Logit(P)=-0.877+0.031Y CA19-9+0.007Y CA50-0.034Y CA242.The AUC,sensitivity and accuracy of the three combined tests were higher than those of CA19-9,CA50 and CA242,and the specificity was lower than that of CA19-9,CA50 and CA242,the differences were statistically significant(P<0.05).Conclusion The combined detection of serum CA19-9,CA50 and CA242 is helpful to the clinical diagnosis and condition evaluation of resectable pancreatic cancer,which is worthy of clinical application.

关 键 词：胰腺癌 肿瘤标志物 受试者工作特征曲线 Logistic回归分析 

分 类 号：R735.9[医药卫生—肿瘤]