应用ROC曲线下面积比较血清胰蛋白酶原-2与CA199对胰腺癌的诊断价值

Area Under ROC Curves in Evaluation and Comparison of Serum Trypsinogen-2 and CA199 in Diagnosis of Pancreatic Cancer

目的比较血清胰蛋白酶原-2与CA199对胰腺癌诊断价值。方法选取中国人民解放军北京军区总医院、石景山医院诊为胰腺癌未经治疗的患者25例;对照组随机选取体检中心健康体检者35例。入组者均留取血清标本,采用ELISA法半定量检测血清胰蛋白酶原-2、CA199的含量。结果胰腺癌组患者血清胰蛋白酶原-2中位数为13.2μg/L,四分位间距为2.25～49.15μg/L,CA199中位数为211.6μg/L,四分位间距为42～326.7μg/L,对照组血清胰蛋白酶原-2中位数为0.8μg/L,四分位间距为0.6～1.2μg/L,CA199中位数为12.8μg/L,四分位间距为6.7～26.4μg/L。以1.85 ng/ml为临界值,此时血清胰蛋白酶原-2鉴别胰腺癌与正常人的敏感度和特异度分别为96%和91.4%,ROC曲线下的面积为0.988。以37.2 U/mL为临界值,CA199鉴别诊断胰腺癌与正常人的敏感度为88%,特异度为82.9%,ROC曲线下的面积为0.906,两者ROC曲线下面积差异无统计学意义。结论血清胰蛋白酶原-2与CA199诊断胰腺癌价值差异无统计学意义,可作为一种非侵入性筛选试验,为临床联合肿瘤标志物筛查胰腺癌提供了手段。

Objective To compare diagnostic value of serum trypsinogen-2 and CA199 in pancreatic cancer. Methods A total of 60 fresh serum samples were collected from the patients, including 25 cases of pancreatic cancer, 35 cases of normal control, detect the level of serum of trypsinogen-2 and CA199 by ELISA. Results The median level of serum trypsinogen-2 was 0.8 μg/L in the controls, interquartile Range was 0.6～1.2 μg/L, 13.2 μg/L and 2.25～49.15 μg/L in pancreatic cancer. The median level of serum CA199 was 12.8μg/L in the controls, interquartile Range was 6.7～26.4 μg/L, 211.6μg/L and 42～326.7μg/L in pancreatic cancer. The sensitivity and specificity for differentiation between pancreatic cancer and control group was 91.4%, 96%, respectively, the area under the ROC curve was 0.989. It was 88% and 82.9%, 0.906 for CA199. There was no statistically differences between the area of ROC curve of trypsinogen-2 and C199. Conclusion There was no statistically differences between the area of ROC curve of trypsinogen-2 and C199 in diagnosis of pancreatic cancer. As a non-invasive screening test, detection of serum trypsinogen-2 can be used to combined tumer markers in screen prophase pancreatic cancer.