188例行手术治疗的胰腺癌患者临床实验室特征分析

Analysis of clinical laboratory parameters of 118 patients treated surgically with pancreatic carcinoma

回顾性分析胰腺癌(PC)患者临床常用实验室指标,寻找胰腺癌早诊及病程进展相关实验室指标。采集2008年至2012年于我院行手术治疗的188例病理确诊为胰腺癌患者的术前临床实验室数据,选择胰腺囊腺瘤作为疾病对照组。结果显示:胰腺癌患者反映肝功能损伤与代谢的指标均显著高于对照组,且远远高于参考范围;而蛋白指标虽在参考范围内,但低于囊腺瘤患者;肾功能、凝血功能与血淀粉酶两组间无显著差异;肿瘤标志物CA199在鉴别诊断胰腺癌与胰腺囊腺瘤的敏感度为82.45%,特异度为82.76%,正确率为82.49%;CA242在鉴别诊断胰腺癌与胰腺囊腺瘤的敏感度为66.07%,特异度为100%,正确率为77.65%;胰腺癌与囊腺瘤两组间HBsAg阳性率无差异。我们的结果提示胰腺癌患者存在不同程度的肝功能损伤与糖代谢异常,CA199与CA242可作为胰腺癌较优的肿瘤标志物,而慢性HBV感染与胰腺癌的发生无相关性。

To retrospectively analyze the routine clinical laboratory parameters for pancreatic carcinoma,The study is aimed to search for correlate parameters,which can be used in early diagnosis and judgment of progression.The pre-operation clinical laboratory datum were collected from 118 patients who were pathologically diagnosed as pancreatic carcinoma and 29 patients who were diagnosed as pancreatic cystadenoma,then the difference of these parameters between two groups was analyzed.The result found that Enzymatic indexes,bilirubin metabolism and lipometabolism indexes were increased significantly in pancreatic carcinoma,compared with pancreatic cystadenoma.Protein metabolism indexes were below disease control group.The sensitivity,specificity and accuracy of CA199 were 82.45%,82.76% and 82.49%for differentiating between pancreatic carcinoma and pancreatic cystadenoma respectively.The sensitivity,specificity and accuracy of CA242 were 66.07%,100% and 77.65%for differentiating between pancreatic carcinoma and pancreatic cystadenoma respectively.Therefore CA199 and CA242 were useful tumor markers in diagnosis of pancreatic carcinoma.There was no correlation between pancreatic cancer and positive rate of HBsAg.