血清肿瘤标志物在老年胰腺癌患者诊断中的应用

Application value of serum tumor markers in diagnosis of pancreatic adenocarcinoma in the elderly

目的探讨血清肿瘤标志物在老年胰腺癌患者诊断中的应用价值。方法选取2009年6月至2012年5月老年胰腺癌患者158例和中青年胰腺癌患者102例，所有患者均经病理学、细胞学和CT确诊。另选取同期良性疾病老年患者和中青年患者各100例作为对照组。对各组患者的血清肿瘤标志物含量水平进行检测，计算其敏感性和特异性并进行组间比较。结果癌胚抗原（CEA）、CA199、CA125、CK19、CA242和CA724老年胰腺癌患者含量分别为（70．9±11．4）μg／L、（158．9±19．1）U／ml、（53．9±15．4）U／ml、（70．2±16．3）U／ml、（96．4士18．5）U／ml和（57．6±13．6）u／m1均高于老年对照组患者（1．6±0．4）μg／L、（12．6±3．2）u／ml、（11．6±1．1）U／ml、（t．4±0．2）U／ml、（7．9±2．2）U／m1和（4．4±0．6）U／ml（t=26．13、31．63、17．57、19．03、20．95、15．59，均P〈O．05）。CEA、甲胎蛋白、CAl99、CA125、CA242老年组的敏感性分别为61．72％、19．56％、80．31％、70．21％及75．24％均高于青年组48．69％、4．13％、69．55％、46．77％及59．44％（x2=4．28、12．63、3．94、14．32、7．23，均P〈0．05）；特异性两组间各指标差异无统计学意义（均P〉0．05）。结论血清肿瘤标志物的检测能够为老年胰腺癌患者的临床诊断提供有效参考，对于患者病情的控制和逆转具有重要的意义。

Objective To explore the clinical value of serum tumor markers including CEA, AFP, CA199, CA125, CK19, CA242 and CA724 in diagnosis of pancreatic adenocarcinoma in the elderly. Methods Totally 158 elderly and 102 middle-aged patients with pancreatic adenocarcinoma were selected. Pancreatic adenocarcinoma in all patients were confirmed by pathological examination, cytological examination and CT. 100 elderly and 100 middle-aged patients with benign diseases were selected as control groups. The levels of serum tumor markers were detected and their sensitivities and specificities were calculated and compared between groups. Results The levels of serum CEA, CA199, CA125, CK19, CA242 and CA724 were higher in elderly patients with pancreatic adenocarcinoma than in the elderly control group [（70.9±11.4） g/L vs. （1.6±0.4） g/L, （158.9± 19.1）U/ml vs. （12.6±3.2）U/ml, （53.9±15.4）U/ml vs. （11.6±1.1）U/ml, （70.2±16.3）U/ml vs. （1.4±0.2）U/ml, （96.4±18. 5）U/ml vs. （7.9±2.2）U/ml, （57.6±13.6）U/ml vs. （4.4±0.6）U/ml, t=-26.13, 31.63, 17.57, 19.03, 20.95, 15.59, respectively, all P〈0.053. The sensitivities of serum CEA, AFP, CA199, CA125, and CA242 were higher in the elderly patients than in the middle aged patients （61.72% vs. 48.69%, 19.56% vs. 4.13%, 80.31% vs. 69.55%, 70.21%vs. 46.77%, 75.24% vs. 59.44%）x2=4.28, 12.63, 3.94, 14.32, 7.23, respectively, all P〈0.05）. The specificities of serum CEA, AFP, CA199, CA125, and CA242 had no significant differences between the elderly and middle aged patients （all P〉0.05）. Conclusions Serum tumor markers may provide effective reference for the clinical diagnosis of pancreatic adenocarcinoma in the elderly, which has important value for pancreatic adenocarcinoma control and reversal.