胰腺癌患者血清CEMIP、CA19-9和CA242水平变化及其临床意义

Changes of serum CEMIP, CA19-9 and CA242 levels in patients with pancreatic cancer and their clinical significance

目的研究胰腺癌患者血清CEMIP、CA19-9和CA242水平变化及其临床意义。方法 2013年4月～2016年8月我院诊治的92例胰腺癌患者、105例胰腺良性疾病患者和选择的83例健康人,采用ELISA法检测血清细胞迁移诱导透明质酸结合蛋白(CEMIP)水平,采用放射免疫法检测血清CA19-9和CA242水平。应用受试者工作特征曲线(ROC)下面积(AUC)评价各指标的诊断效能。采用Kaplan-Meier和Cox风险比例模型行生存分析。采用Logistic回归分析影响术后生存的因素。结果胰腺癌患者血清CEMIP、CA19-9和CA242水平分别为0.7(0.4,1.0) ng/mL、180.1(89.1,230.3) U/mL和61.7(20.7,93.5)U/mL,均显著高于胰腺良性疾病患者和健康人,差异有统计学意义(P均<0.05);应用血清CEMIP、CA19-9和CA242联合诊断胰腺癌的AUC为0.966,其诊断效能显著高于任一指标单独诊断;应用血清CEMIP、CA19-9和CA242水平预测胰腺癌患者根治术后1年生存的效能均较高;经Kaplan-Meier和Cox多因素分析,结果表明肿瘤分化程度、血管侵犯、术后化疗、血清CEMIP≥0.7ng/mL、CA19-9≥90.3 U/mL和CA242≥32.8 U/mL均是影响胰腺癌患者根治术后生存的独立危险因素。结论检测胰腺癌患者血清CEMIP、CA19-9和CA242水平可有助于对疾病的诊断和预后评估。

Objective To study the changes and significance of serum cell migration induced hyaluronan-binding protein(CEMIP),carbohydrate antigen 19-9(CA19-9 and CA242 in patients with pancreatic cancer(PC).Methods A total of 92 patients with PC,105 patients with benign pancreatic diseases,and 83 healthy volunteers were recruited in our hospital beteen April 2013 and August 2016,and serum CEMIP levels were measured by ELISA,serum CA19-9 and CA242 levels were measured by radioimmunoassay.The area under the receiver-operating characteristic curve(AUC)was applied to evacuate the diagnostic efficacy,Kaplan-Meier and Cox proportional hazard model was applied for the survival analysis and Logistic regression was applied to analyze the risk factors impacting the survival.Results Serum levels of CEMIP,CA19-9 and CA242 in patients with PC were 0.7(0.4,1.0)ng/mL,180.1(89.1,230.3)U/mL and 61.7(20.7,93.5)U/mL,respectively,much higher than those in patients with benign pancreatic disease or healthy controls(P<0.05);the AUC of combined serum CEMIP,CA19-9,and CA242 in diagnosis of patients with PC was 0.966,and its diagnostic efficacy was higher than either of the three parameters alone;serum CEMIP,CA19-9,and CA242 levels could predict effectively the survival of patients with PC at the end of 1 year after radical removal of the tumor;Kaplan-Meier and Cox multivariate analysis showed that tumor differentiation,vascular invasion,postoperative chemotherapy,serum CEMIP≥0.7 ng/mL,CA19-9≥90.3 U/mL,and CA242≥32.8 U/mL were the independent risk factors influencing the survival of patients with PC after operation.Conclusion The detection of serum CEMIP,CA19-9 and CA242 levels in patients with PC might help to diagnose the disease and evaluate the prognosis.