血清CA19-9、PIVKA-Ⅱ、VEGF联合检测对胰腺癌的诊断价值研究

Diagnostic value of combined detection of serum CA19-9,PIVKA-Ⅱ,VEGF in pancreatic cancer

目的探讨血清糖蛋白抗原199(CA19-9)、异常凝血酶原(PIVKA-Ⅱ)、表皮生长因子(VEGF)联合检测对胰腺癌的诊断价值。方法对73例胰腺癌患者(胰腺癌组),71例胰腺良性病变者(胰腺良性病变组)和56例健康对照者(健康对照组),分别进行血清CA19-9、PIVKA-Ⅱ、VEGF水平的检测,并对检测结果进行统计分析,探讨其对胰腺癌的诊断价值。结果胰腺癌组血清PIVKA-Ⅱ水平显著高于健康对照组、胰腺良性病变组,差异有统计学意义(Z=-6.18、-1.94,均P<0.05),而胰腺良性病变组与健康对照组之间,差异无统计学意义(Z=-1.30,P>0.05)。血清CA19-9水平在胰腺癌组高于健康对照组、胰腺良性病变组,差异有统计学意义(Z=-7.69、-2.10,均P<0.05),而胰腺良性病变组与健康对照组之间差异无统计学意义(Z=-1.01,P>0.05)。用于评价胰腺癌的受试者工作特征曲线下面积CA19-9最大(0.798),CA19-9、PIVKA-Ⅱ曲线下面积差异均具有统计学意义(P<0.05)。CA19-9、PIVKA-Ⅱ、VEG 3项联合检测可使诊断的灵敏度和阴性预测值分别提高到87.80%和75.50%,特异度和准确度均维持在70.00%左右。结论 CA19-9、PIVKA-Ⅱ和VEGF对胰腺癌的诊断均具有重要临床价值;CA19-9、PIVKA-Ⅱ和VEGF联合检测可提高胰腺癌的诊断灵敏度。

Objective To investigate the diagnostic value of serum CA19-9,PIVKA-Ⅱ,VEGF in pancreatic cancer.Methods A total of 73 pancreatic cancer patients,71 benign pancreatic patients and 56 healthy controls were collected.The results were analyzed statistically to explore the diagnostic value of serum levels of CA19-9,PIVKA-Ⅱ and VEGF for pancreatic cancer.Results The serum PIVKA-Ⅱ level in pancreatic cancer group was significantly higher than that in healthy control group and benign pancreatic lesion group(Z=-6.18,-1.94,all P<0.05),but there was no significant difference between benign pancreatic lesion group and healthy control group(Z=-1.30,P>0.05).The level of serum CA19-9 in pancreatic cancer group was higher than that in healthy control group and benign pancreatic lesion group(Z=-7.69,-2.10,all P<0.05),but there was no significant difference between benign pancreatic lesion group and healthy control group(Z=-1.01,P>0.05).The CA19-9 of area under ROC curve for pancreatic cancer patients was the largest(0.798),and the area under CA19-9 and PIVKA-Ⅱ curve was significantly different(P<0.05).The combined detection of CA19-9,PIVKA-Ⅱ and VEG could increase the sensitivity and negative predictive value of diagnosis to 87.80% and 75.50% respectively,and the specificity and accuracy were maintained at about 70.00%.Conclusion CA19-9,PIVKA-Ⅱ and VEGF have important clinical value in the diagnosis of pancreatic cancer.The combined detection of CA19-9,PIVKA-Ⅱ and VEGF can improve the diagnostic sensitivity of pancreatic cancer.