用于胰头癌可切除性判断的术前血清标志物筛选

发布时间：2018-06-30 06:25

本文选题：胰腺肿瘤 + 胰腺切除术　；参考：《中国普通外科杂志》2017年03期

【摘要】：目的:探讨术前血清肿瘤标记物糖类抗原(CA19-9、CA50、CA242、CA125)和癌胚抗原(CEA)水平对胰头癌可切除性评估的临床价值。方法:回顾性分析2014年1月—2015年12月收治的104例胰头癌患者的临床资料,筛选与胰头癌可切除性相关的血清肿瘤标记物,并采用受试者工作特性曲线(ROC)与曲线下面积(AUC)分析其对胰头癌可切除性的预测价值。结果:104例患者均行手术探查,其中可切除54例(可切除组),不可切除50例(不可切除组)。两组术前血清CA50和CEA水平差异无统计学意义(均P0.05),而不可切除组CA19-9、CA242和CA125水平明显高于可切除组(317.99k U/Lvs.152.98k U/L;67.81k U/Lvs.39.36k U/L;71.53k U/Lvs.29.22k U/L,均P0.05)。ROC分析得出CA19-9和CA125对胰头癌可切除性均具有判断价值,其最佳截断点分别为236.13k U/L和16.44k U/L,AUC值分别为0.667和0.678(均P0.05),而单项检测CA242对胰头癌可切除性诊断无明显判别价值(AUC=0.609,P=0.085)。CA19-9、CA125联合诊断对胰头癌可切除性诊断的灵敏度和特异性提高。结论:术前检测血清CA19-9和CA125水平可作为辅助指标应用于胰头癌的可切除性评估,两者联合检测更能提高灵敏度和特异性。
[Abstract]:Objective: to evaluate the clinical value of preoperative serum tumor marker carbohydrate antigen (CA19-9) CA50 CA242CA125 and carcinoembryonic antigen (CEA) in evaluating the resectability of pancreatic head carcinoma. Methods: the clinical data of 104 patients with pancreatic head carcinoma from January 2014 to December 2015 were retrospectively analyzed and serum tumor markers associated with resectability of pancreatic head carcinoma were screened. The predictive value of operating characteristic curve (ROC) and area under curve (AUC) for resectability of pancreatic head carcinoma was analyzed. Results all 104 cases underwent surgical exploration, 54 cases were resectable (resectable group) and 50 cases were unresectable group (unresectable group). There was no significant difference in serum CA50 and CEA levels between the two groups before operation (P0.05), but CA19-9 CA242 and CA125 levels in the unresectable group were significantly higher than those in the resectable group (317.99k / L / L vs. 152.98k / L / L 67.81k / U / L / 39.36k / L / L 71.53k / L / L 29.22k / L, P0.05) .ROC analysis showed that CA19-9 and CA125 were valuable in judging the resectability of pancreatic head cancer. The optimal cut-off points were 236.13 KU / L and 16.44 KU / L, respectively, and the AUC values were 0.667 and 0.678, respectively (P0.05). The sensitivity and specificity of the combined diagnosis of CA19-9 and CA125 in the diagnosis of resectability of pancreatic head carcinoma had no significant discriminant value (AUC0.609P0.085), and the sensitivity and specificity of CA19-9 / CA125 combined diagnosis for resectability of pancreatic head carcinoma were improved. Conclusion: preoperative detection of serum CA19-9 and CA125 levels can be used as an auxiliary index to evaluate the resectability of pancreatic head carcinoma. The combined detection of CA19-9 and CA125 can improve the sensitivity and specificity.
【作者单位】：安徽医科大学附属安徽省立医院普通外科胆胰病区/肝胆胰安徽省重点实验室;
【基金】：安徽省自然科学基金资助项目(1408085QH188) 安徽省科技计划基金资助项目(1506c085018)
【分类号】：R735.9

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