血清CA724、CA199、CEA及CA125在诊断胰腺癌中的临床价值

Clinical values of CA724,CA199,CEA and CA125 in diagnosis of pancreatic carcinoma

目的探讨肿瘤标志物糖类抗原724(CA724)、糖类抗原199(CA199)、癌胚抗原(CEA)、糖类抗原125(CA125)单独或联合检测在胰腺癌早期诊断中的临床价值。方法选取2017年5月-2018年5月就诊龙岩市第一医院的31例胰腺癌患者、31例良性胰腺疾病患者和34例健康体检者,采用电化学发光法对各组血清CA724、CA199、CEA、CA125进行检测并分析各指标间的相关性。同时采用ROC曲线分析各指标单项或联合测定在胰腺癌中的诊断效能。结果胰腺癌组血清CA199、CEA、CA125水平显著高于良性胰腺疾病组和健康对照组(P均<0.05),而CA724仅高于良性胰腺疾病组(P<0.05),CEA与CA125间存在较好相关性(r=0.764,P=0.000)。胰腺癌组CA199的曲线下面积(ROC AUC)为0.953,敏感度、特异度分别为83.90%、100.00%。CA199联合CEA的ROC AUC为0.983,敏感性为93.50%,高于CA199联合CA724或CA125。4项指标联合检测的ROC AUC最大,为0.991,高于单项和其他指标联合检测,敏感性和特异性分别为96.80%和100.00%,且曲线下面积间比较差异无统计学意义(P>0.05)。结论CA199在胰腺癌中的诊断效能明显优于CEA、CA125、CA724,联合检测提高了胰腺癌诊断的敏感性,对提高胰腺癌的诊断具有临床意义。

Objective To explore the clinical application values of serum tumor markers carbohydrate antigens(CA)724,CA199,CEA and CA125 in diagnosis of pancreatic carcinoma. Methods Thirty one pancreatic cancer patients(pancreatic cancer group)and 31 patients with benign pancreatic diseases(benign pancreatic diseases group)who cared at Longyan First Hospital from May 2017 to May 2018 were selected in this study,and 33 healthy individuals who received health examination at the same time were selected as health control group.The serum CA724,CA199,CEA and CA125 in each group were detected by electrochemical luminescence method and the correlation between every index was analyzed.The diagnostic efficiency of each single or combined indicators in pancreatic cancer was analyzed by using the receiver operating characteristic curves(ROC). Results Serum CA199,CEA and CA125 levels in the pancreatic cancer group were significantly higher than those in benign pancreatic diseases group and health control group(all P <0.05),and the CA724 level in the pancreatic cancer group was only higher than that in benign pancreatic diseases group(P <0.05).There was a good correlation between CEA and CA125(r =0.764,P =0.000).The ROC AUC of CA199 in pancreatic cancer patients was 0.953,the sensitivity and specificity of CA199 were 83.90%and 100.00%respectively.The ROC AUC of the allied detection of the CA199 and CEA for pancreatic cancer patients was 0.983,the sensitivity was 93.50%,which was higher than those allied detection of CA199 and CA724 or CA125.The allied detection for four indicators got the maximum ROC AUC(0.991),which was higher than single and or other allied detection,the sensitivity and specificity were 96.80% and 100.00%,moreover,the comparison of ROC AUC showed no statistically significant difference(P >0.05). Conclusion The diagnostic efficiency of CA199 in pancreatic cancer is superior to those of CEA,CA125 and CA724.Allied detection can improve the sensitivity in diagnosis of pancreatic cancer,which has great clinical significance to improve the diagnosis of pancreatic cancer.