CA19-9和IL-33对胰腺癌的临床诊断价值分析

The clinical value of CA19-9 and IL-33 in the diagnosis of pancreatic cancer

目的评估白细胞介素-33(interleukin-33,IL-33)和糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)对胰腺癌的临床诊断价值。方法选取50例胰腺癌患者、70例胰腺炎患者、50名健康人群作为研究对象,比较3组患者外周血内IL-33和CA19-9水平,评价IL-33和CA19-9单独应用及联合应用对胰腺癌的诊断灵敏度、特异度和准确率,并比较不同病理分期胰腺癌患者外周血内IL-33和CA19-9的水平差异。结果 CA19-9水平超过临界值37 U/ml时对胰腺癌的诊断准确率为96.70%,当超过100 U/ml时诊断准确率有所上升,但超过1 000 U/ml时其诊断精确度却不再上升;当IL-33水平超过临界值50 pg/ml时对胰腺癌的诊断具有较高准确率,且在超过100 pg/ml时有所增长,但超过300 pg/ml时其诊断正确率不再明显上升。CA19-9单独应用诊断胰腺癌的灵敏度、特异性及准确率均高于IL-33,两者联合应用可提高诊断诊断灵敏度和准确性,但特异性略有下降。不同病理分期胰腺癌外周血内的IL-33和CA19-9水平差异均有统计学意义,随着病理程度的严重,IL-33和CA19-9的水平呈上升趋势(P<0.05)。结论IL-33和CA19-9对胰腺癌的确诊和病理分期评估均有重要价值,且能弥补影像学诊断胰腺癌的不足,值得临床推广。

Objective To assess the clinical value of interleukin 33 （IL-33） and carbohydrate antigen 19-9 （CA19- 9） in diagnosis of pancreatic cancer. Methods Fifty cases pancreatic cancer patients, 70 cases pancreatitis patients and 50 healthy people were chosen as the research objects. The IL-33 and CA19-9 level of patients in peripheral blood were compared in 3 groups. The IL-33 and CA19-9 used alone and combined use of pancreatic cancer to evaluate diagnostic sensitivity, specificity and accuracy, and the IL-33 and CA19-9 level of patients in peripheral blood in different patho- logical stages were compared. Results The accurate rate of CA19-9 level more than critical value 37 U/ml on pancreat- ic cancer diagnosis was 96.70% , when more than 100 U/ml diagnosis accurate rate would increased, but more than 1 000 U/ml when the diagnostic accuracy was no longer rising; when IL-33 level more than critical value 50 pg/ml in the diagnosis of pancreatic cancer with high accuracy, and when it more than 100 pg/ml increased, but when the diag- nosis accuracy rate more than 300 pg/ml would have no obvious rise. The sensitivity, specificity and accuracy of CA19-9 in the diagnosis of pancreatic cancer were higher than those of IL-33, but their combined use can improve the sensitivity and accuracy of diagnosis, but the specificity decreased slightly. There were significant differences in IL-33 and CA19-9 levels in the peripheral blood of pancreatic cancer patients in different pathological stages. The level of IL-33 and CA19-9 showed an upward trend with the severity of pathology （P 〈 0.05）. Conclusion IL-33 and CA19-9 have important val- ue in the diagnosis and staging of pancreatic cancer, and can make up the deficiency of imaging diagnosis of pancreatic cancer, which is worthy of clinical application.