血清D-二聚体、CA-199、CA-125、CA-724及CEA对鉴别胰腺癌和慢性胰腺炎的临床应用价值

Clinical Value of Serum Level of D-dimer,CA-199,CA-125,CA-724 and CEA for Differential Diagnosis of Pancreatic Cancer and Chronic Pancreatitis

目的探讨血清D-二聚体、CA-199、CA-125、CA-724和CEA在慢性胰腺炎和胰腺癌鉴别诊断中的临床应用价值。方法方便选取无锡市第二人民医院2012年1月—2015年12月收治的胰腺癌患者30例、慢性胰腺炎患者30例,分别作为胰腺癌组和慢性胰腺炎组并检测D-二聚体、CA-199、CA-125、CA-724及CEA 5个观察指标。两组分别使用免疫比浊法进行血浆D-二聚体检测以及使用化学发光法进行4个肿瘤标志物检测。结果胰腺癌组D-二聚体值(1.67±0.26)、CA-199值(462.1±126.5)、CA-125值(330.7±133.2)、CA724值(16.4±10.52)和CEA值(31.84±12.39);慢性胰腺炎组D-二聚体值(0.22±0.04)、CA-199值(83.69±33.36)、CA-125值(15.97±2.78)、CA724值(9.54±7.68)和CEA值(4.44±0.76)。其中D-二聚体、CA-199、CA-125及CEA检测值在胰腺癌组显著高于在慢性胰腺炎组,两组比较差异有统计学意义(P<0.05)。另外,D-二聚体在两组比较中敏感性和特异性分别为60.0%和96.7%;CA-199敏感性及特异性分别是66.7%和70.0%;CA-125的敏感性和特异性分别是63.3%和86.7%;CEA的敏感性和特异性分别是33.3%和90.0%,其中D-二聚体、CA-199、CA-125个指标在两组比较差异有统计学意义(P<0.05)。结论 D-二聚体、CA-199和CA-125在鉴别慢性胰腺炎和胰腺癌具有较好应用价值,总体来说综合敏感性和特异性的检测结果 ,D-二聚体指标在鉴别诊断应用方面优于CA-199和CA-125。

Objective To explore clinical value of D-dimer,CA-199,CA-125,CA-724 and CEA for differential diagnosis of pancreatic cancer（PC） and chronic pancreatitis（CP）. Methods Convenient selection 30 patients with pancreatic cancer and 30 patients with chronic pancreatitis from January 2012 to December 2015 were enroll ed to PC group and CP group respectively and the sserum level of D-dimer,CA-199,CA-125,CA-724 and CEA were tested in this retrospective analysis. The serum level of D-dimer was detected by immunoturbidimetry and the serum level of four tumor markers was detected by chemiluminescence. Results Level of D-dimer,CA-199,CA-125,CA-724 and CEA in CP group are（0.22±0.04）,（83.69 ±33.36）,（15.97 ±2.78）,（9.54 ±7.68） and（4.44 ±0.76）, respectively while in PC group are（1.67 ±0.26）,（462.1±126.5）,（330.7±133.2）, 16.4±10.52） and（31.84±12.39）, respectively. The level of D-dimer,CA-199,CA-125 and CEA are significantly higher in PC group than those in CP group（P〈0.05）.Sensitivity and specificity of D-Dimer are 60.0%and 96.7% in PC versus CP group, while sensitivity and specificity of CA-199 are 66.7% and 70.0%; CA-125 63.3% and86.7%; 33.3% and 90.0% for CEA. The sensitivity and specificity difference are significant in D-dimer, CA-199 and CA-125 between the two groups（P〈0.05）. Conclusion In differential diagnosis for pancreatic cancer and chronic pancreatitis,serum level of D-dimer and CA-199, CA-125 have shown promising value. Generally speaking, combined with both sensitivity and specificity test D-dimer is more applicable than the tumor markers.