血清中4种肿瘤标志物检测对胰腺癌诊断的意义

Diagnosis of Pancreatic Cancer through Detecting 4 Tumor Markers in Serum

目的研究与胰腺癌(PC)相关的血清中恶性肿瘤相关物质(TSGF)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)和糖类抗原242(CA242)4种肿瘤标志物的临床应用价值。方法采用生化比色法和AXSYM免疫分析仪,分别检测46例胰腺癌患者,40例胰腺炎及100例健康成人血清中的TSGF、CEA、CA19-9及CA242含量。结果单项肿瘤标志物检测,4种肿瘤标志水平均高于正常人和胰腺炎患者,且差异均有非常显著性(P<0.001)。TSGF敏感性最高达87.0%,特异性CA242最高达89.0%,有效性CA242与CA19-9相近。各种组合检测中,敏感性以TSGF+CA19-9+CA242和TSGF+CEA+CA19-9+CA242组最高(95.7%),但特异性、有效性和阳性预测值4项组合稍低于3项组合。有效性和阳性预测值以TSGF+CA242组合最高,且敏感性和特异性也较高。结论从敏感性、特异性、有效性和阳性预测值以及减轻病人经济负担综合考虑,TSGF+CA242组合优于其他联合形式,在胰腺癌诊断治疗中,具有一定的临床应用价值。

[Objective] To explore the clinical value of 4 tumor markers, namely the tumor specific growth factor (TSGF), carcinoembryonic antigen (CEA), CA 19-9 and CA 242 in the serum of pancreatic cancer (PC) patients. [Methods] Biochemistry Colorimetry and AXSYM analyzer were applied to detect the content of TSGF, DEA CA 19-9 and CA 242 in the serum of 46 PC patients, 40 pancreatic inflammation patients and 100 healthy adults. [Results] The level of all the 4 tumor markers of the pancreatic cancer patients was higher than that of the healthy people and pancreatic inflammation patients, the difference was significant (P< 0.001) . The highest sensitivity of TSGF was 87.0%; the highest specificity of CA 242 reached to 89.0%; the effectiveness of CA 242 and CA 19-9 was very close. The highest sensitivity (95.7%) was found in (TSGF+CA 19-9+CA 242) group and (TSGF+CEA+CA 19-9+CA 242) group, while the specificity, effectiveness and positive estimated value in 4-item combinations were slightly lower than that in the 3-item combinations. The highest effectiveness and positive estimated value were found in (TSGF+CA 242) group, so were the sensitivity and specificity. [Conclusion] (TSGF+CA 242) group is superior to other combinations in sensitivity, specificity, effectiveness and positive estimated value and is more economical for the patients. This method has certain clinical value in diagnosing and treating pancreatic cancer.