多种肿瘤标志物在胰腺癌中的诊断价值及相关性研究

发布时间：2018-05-21 13:26

  本文选题：胰腺癌 + 肿瘤标志物　； 参考：《中国免疫学杂志》2017年01期

【摘要】：目的:探讨血清肿瘤标志物联合检测对胰腺癌的诊断价值及相关性。方法:选取2013年1月至2016年5月我院胰腺癌患者146例,非胰腺癌患者128例和健康体检者124例,放射免疫分析仪检测各组血清CA19-9、CA242、CA50、CA125、CEA及TSGF水平,并进行各组间比较。绘制受试工作特征曲线(ROC)分析各肿瘤标志物在胰腺癌患者中的诊断价值,线性相关分析各肿瘤标志物的相关性。应用多元Logistic回归模型分析胰腺癌的独立危险因素。结果:胰腺癌组血清CA19-9、CA242、CA50、CA125、CEA及TSGF水平明显高于对照组和非胰腺癌组,差异有统计学意义(P0.05或P0.01)。Ⅳ期和Ⅲ期患者血清CA19-9、CA242、CA50、CA125及TSGF水平明显高于Ⅰ期和Ⅱ期(P0.01),且Ⅳ期患者血清CA19-9、CA242、CA125及CEA水平明显高于Ⅲ期(P0.01)。胰腺癌组血清CA19-9、CA242、CA50、CA125、CEA及TSGF的阳性率明显高于对照组和非胰腺癌组(P0.01)。ROC曲线显示,血清CA19-9的AUC高于其他单项指标,其最佳临界值、灵敏度和特异度分别为114.5 U/ml、81.2%和79.3%。6项联合检测的诊断效能均优于各单项检测,其灵敏度和特异度分别为92.4%和76.5%。相关性分析显示,血清CA19-9与CA242、CA50及CA125均呈正相关(r=0.703,P=0.005;r=0.572,P=0.024;r=0.439,P=0.036)。多元Logistic回归分析显示,吸烟、不正确的饮食习惯、糖尿病史、胆系疾病史及CA19-9、CA242、CEA进入回归模型,其OR值及95%CI分别为1.717(0.736~2.359)、2.865(2.217~3.685)、2.614(2.186~3.127)、3.527(2.842~4.377)、4.214(3.570~4.962)、2.315(2.114~2.539)、1.876(1.175~2.852)。结论:血清肿瘤标志物联合检测有助于提高早期胰腺癌诊断的准确性,吸烟、不正确的饮食习惯、糖尿病史、胆系疾病史及高水平的CA19-9、CA242、CEA是胰腺癌的独立危险因素。
[Abstract]:Objective: to investigate the diagnostic value and correlation of serum tumor markers in pancreatic cancer. Methods: from January 2013 to May 2016, 146 patients with pancreatic cancer, 128 patients with non-pancreatic cancer and 124 healthy controls were selected. Serum CA19-9, CA242CA50, CA125CEA and TSGF levels were measured by radioimmunoassay. The diagnostic value of each tumor marker in pancreatic cancer patients was analyzed by drawing the work characteristic curve of the subjects, and the correlation of each tumor marker was analyzed by linear correlation analysis. Multivariate Logistic regression model was used to analyze the independent risk factors of pancreatic cancer. Results: the serum levels of CEA and TSGF in patients with pancreatic cancer were significantly higher than those in control group and non-pancreatic cancer group. The serum levels of CA19-9, CA242CA50, CA50, CA125 and TSGF in patients with stage 鈪，

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