摘要
目的探讨血清CA19-9、CA125、CEA、CYFRA21-1、CA15-3和Galectin-3的单项检测和联合检测在胰腺病变鉴别诊断中的作用。方法用雅培ARCHITECT i2000化学发光免疫分析仪分别检测125例胰腺导管腺癌患者和115例胰腺炎患者血清中的CA19-9、CA125、CEA、CYFRA21-1、CA15-3和Galectin-3水平。结果经受试者工作特征曲线(receiver operating characteristic curve,ROC)分析,CA19-9的曲线下面积(area under the curve,AUC)最大,为0.856,灵敏度和特异性分别75.2%和92.2%,其次为CA125(AUC=0.706),CEA(AUC=0.689)和CYFRA21-1(AUC=0.672)。而CA15-3(AUC=0.568)和Galectin-3(AUC=0.537)很难鉴别胰腺癌和胰腺炎。CA19-9、CA125和CEA联合检测的AUC为0.910,灵敏度和特异性分别为77.6%和93.9%,均高于CA19-9单项指标。CA125和CYFRA21-1在胰腺癌晚期组的血清水平明显高于早期组(P<0.05),而其他四项指标没有显著差异(P>0.05)。结论血清CA19-9在胰腺病变鉴别诊断中具有重要的价值,而Galectin-3的价值不高,血清CA19-9、CA125和CEA的联合检测可提高CA19-9单项对胰腺癌的诊断效能。CA125和CYFRA21-1和胰腺癌的肿瘤分期相关。
Objective To investigate the significances of CA19-9,CA125,CEA,CYFRA21-1,CA15-3 and Galectin-3 in the differential diagnosis of pancreatic lesion.Methods Levels of CA19-9,CA125,CEA,CYFRA21-1,CA15-3 and Galectin-3 in the serum of 125 patients with pancreatic ductal adenocarcinoma(PDAC)and 115 patients with pancreatitis were detected by Abbott ARCHITECT i2000 chemiluminescence immunoassay analyzer.Results According to ROC analysis,the maximum AUC was achieved in CA19-9(AUC=0.856),followed by CA125(AUC=0.706),CEA(AUC=0.689)and CYFRA21-1(AUC= 0.672 ).The sensitivity and specificity of CA19-9 were 75.2% and 92.2%,respectively,while CA15-3( AUC= 0.568 )and Galectin-3(AUC=0.537)were difficult to differentiate between PDAC and pancreatitis.When combined CA19-9,CA125 and CEA,it yielded an AUC of 0.910 with higher sensitivity(77.6%)and specificity(93.9%),compared to CA19-9.The serum levels of CA125 and CYFRA21-1 in the advanced PDAC group were significantly higher than those in the early PDAC group(P<0.05),while the other four biomarkers showed no significant differences(P>0.05).Conclusion CA19-9 is of great value in the differential diagnosis of pancreatic lesion,while Galectin-3 is of little value.Combination of CA19-9,CA125 and CEA has superior diagnostic capability to CA19-9 alone.CA125 and CYFRA21-1 are associated with tumor staging in PDAC.
作者
黄媛
阳振曦
崔巍
齐志宏
HUANG Yuan;YANG Zhen-xi;CUI Wei;QI Zhi-hong(Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,100730,China;Peking Union Medical College,100730,China;Department of Clinical Laboratory,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100021,China)
出处
《标记免疫分析与临床》
CAS
2019年第5期763-767,共5页
Labeled Immunoassays and Clinical Medicine
基金
中国医学科学院医学与健康科技创新工程,协同创新团队项目(编号:2017-12M-3-005)
