2型糖尿病与血清糖类抗原19—9浓度相关性研究

Correlation study of type 2 diabetes mellitus and serum carbohydrate antigen 19-9 level

目的对2型糖尿病患者血清糖类抗原19-9（CA19-9）浓度变化进行观察，并探讨鉴别消化道恶性肿瘤与2型糖尿病的CA19-9阳性界值。方法回顾性分析300例入选者，2型糖尿病组（A组）100例，肿瘤组（B组）80例，非肿瘤非糖尿病组（c组）120例，用化学发光法测定各组患者血清CA19-9浓度，进行对比分析。结果A、B两组血清CA19-9浓度明显高于C组[（21．38±18．23）、（32．21±19．00）kU／L比（11．21±10．08）kU／L]，差异有统计学意义（P〈0．05），且B组血清CA19-9浓度显著高于A组，差异有统计学意义（P〈0．05）；血清CA19-9浓度与空腹血糖（r=0．527，u=5．144，P〈0．01）、餐后2h血糖（r=0．617，u=6．044，P〈0．01）、空腹胰岛素（r=0．427，u=4．144，P〈0．01）、糖化血红蛋白（r=0．507，u=4．881，P〈0．01）有关，而与血清肌酐、2型糖尿病病程等无关；ROC曲线确定血清CA19-9在A、B两组间的阳性界值为45．0kU／L。结论2型糖尿病患者血清CA19-9浓度较正常人高，但低于消化道恶性肿瘤患者，且其与血糖、糖化血红蛋白相关，把45．0kU／L作为血清CA19-9诊断的阳性界值可明显利于消化道恶性肿瘤的诊断。

Objective To observe the changes of carbohydrate antigen 19-9 （CA19-9） in type 2diabetes mellitus （T2DM） patients, and determine the positive boundary value of CA19-9 for differentiating digestive tract malignant tumor and T2DM. Methods The clinical data of 300 cases were retrospectively analyzed. The patients were divided into 3 groups：group A with 100 T2DM patients,group B with 80 tumor patients and group C with 120 non-tumor and non-diabetic mellitus normal people. Chemiluminescence was used to determine the serum CA19-9 level,and the results of the 3 groups were analyzed. Results The serum CA 19-9 levels in group A and group B were significantly higher than that in group C [ （21.38 ± 18.23 ）, （32.21 ± 19.00） kU/L vs. （11.21 ± 10.08） kU/L],and there were statistical differences （P 〈0.05）. Furthermore the serum CA19-9 level in group B was significantly higher than that in group A, and there was statistical difference （P 〈 0.05）. The serum CA19-9 level was associated with fasting plasma glucose （r = 0.527, u = 5.144, P 〈 0.01 ）, 2 h postprandial blood glucose （r = 0.617, u = 6.044, P 〈 0.01 ）, fasting insulin （r = 0.427, u = 4.144, P 〈 0.01 ）, and glycosylated hemoglobin （r = 0.507, u = 4.881, P 〈 0.01 ）, while the serum CA19-9 level was not associated with serum creatinine and courses of T2DM. CA19-9 ROC curve was used to determine 45.0 kU/L as the positive boundary value between the group A and group B. Conclusions The serum CA19-9 level of T2DM patients is higher than that of normal people, but lower than that of patients with digestive tract malignant tumor. The serum CA19-9 level is associated with blood glucose and glyeosylated hemoglobin. The 45.0 kU/L as serum CA19-9 level positive boundary value can significantly improve the diagnosis value of digestive tract malignant tumor.