胰腺癌肿瘤标志物单项和联合检测的价值

Application of single and combined assay of serum tumor markers in the diagnosis of pancreatic cancer

目的 评价血清肿瘤标志物单项检测和联合检测对胰腺癌诊断的意义。方法 对 10例慢性胰腺炎和 5 1例胰腺癌病人用放免法测定血清CA199,CA5 0 ,CA12 5和CEA含量 ,分析并比较单项检测和联合检测的意义。结果 4种肿瘤标志物单项检测以CA199对胰腺癌诊断意义最大 ,敏感性和特异性最好 ,分别达 92 5 %和 81 81% ,误检率 18 18% ,漏检率 7 5 % ,阳性预测值94 87% ,阴性预测值 75 % ,研究还发现CA199特别对早期胰体癌诊断有较大意义 ;联合检测以CA199+x(CA5 0 ,CA12 5 ,CEA任一阳性 )意义较大 ,敏感性 87 5 % ,特异性 81 81% ,误检率 18 18% ,漏检率 12 5 % ,阳性预测值 94 5 9% ,阴性预测值 6 4 2 8% ;但诊断价值不大于CA199单项检测 (P >0 0 5 )。结论 CA199检测对胰腺癌诊断意义较大 ,特别对早期胰体癌诊断有较大意义 ;联合检测并不能提高CA199的诊断价值 ,却增加医疗费用 。

Aim To evaluate the value of serum tumor markers in the diagnosis of pancreatic cancer by application of single and combined assay of CA199,CA50,CA125 and CEA.Method We detected tumor markers CA199,CA50,CA125 and CEA in 51 patients with pancreatic cancer and 10 patients with chronic pancreatitis using radio immune assay,and compared the significance between single and combined assay of these tumor markers.Result CA199 was the best diagnostic index among them;its sensitivity and specificity were 92.5% and 81.18% respectively.Its error rate and lose rate were 18.18% and 7.5% respectively;and its postive forcasting rate and negetive forcasting rate were 94.87% and 75%.We also discovered that CA199 had important value for early diagnosis of pancreatic body cancer especially.The combined assay of CA199 and x(any positive for CA50,CA125 and CEA)had important value compared with any other combined assay and sensitivity and specificity were 87 5% and 81.18% respectively.Its error rate and lose rate were 18.18% and 12.5% respectively;and its positive forcasting rate and negetive forcasting rate were 94.59% and 64.28% respectively.But there was no significance compared with single CA199 assay.Conclusion These results suggest that single CA199 tumor marker assay is helpful to early diagnosis of pancreatic cancer,especially for body pancreatic cancer.The combined assay was of no significance,while increasing medical cost of patients.