血清CA19-9、CEA、gal-3水平对胰腺癌的诊断价值及其与病理特征的关系

Analysis of the value of serum CA19-9,CEA and gal-3 in the diagnosis of pancreatic cancer and its relationship with pathological features

目的:分析血清糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、半乳糖凝集素3(gal-3)水平对胰腺癌的诊断价值及其与病理特征的关系。方法:选取90例胰腺癌患者设为胰腺癌组,另选取同期120例胰腺炎患者设为对照组。采用受试者工作曲线(ROC)评估血清CA19-9、CEA、gal-3水平对胰腺癌的诊断价值;分析血清CA19-9、CEA、gal-3水平与胰腺癌患者临床病理特征的关系。所有患者术后均获得随访,分析血清CA19-9、CEA、gal-3水平与患者预后的关系。结果:胰腺癌组患者血清CA19-9、CEA、gal-3水平均高于胰腺炎组(P<0.05)。血清CA19-9、CEA、gal-3水平及三者联合诊断胰腺癌的ROC曲线下面积(AUC)分别为0.875、0.764、0.835、0.905,三者联合对胰腺癌诊断特异度优于血清CA19-9、CEA、gal-3单独检测。肿瘤>3 cm、TNM为Ⅲ期、淋巴结转移的胰腺癌患者血清CA19-9、CEA、gal-3水平高于肿瘤≤3 cm、TNM为Ⅰ~Ⅱ期、无淋巴结转移的患者(P<0.05)。血清CA19-9高水平组无进展生存期(PFS)、总生存期(OS)大于CA19-9低水平组(P<0.05),CEA高水平组PFS、OS大于CEA低水平组(P<0.05),gal-3高水平组PFS、OS大于gal-3低水平组(P<0.05)。结论:血清CA19-9、CEA、gal-3水平对胰腺癌具有诊断价值,三者联合检测可提高诊断效能,且各指标与患者临床病理特征及预后有关,可作为患者病情诊断和预后评估指标。

Objective:To analyze the diagnostic value of serum carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA) and galactose lectin 3(gal-3) in pancreatic cancer and its relationship with pathological features.Methods: A total of 90 patients with pancreatic cancer and 120 patients with pancreatitis in the same period were selected as the pancreatic cancer group and the control group.The diagnostic value of serum CA19-9,CEA and gal-3 in pancreatic cancer was evaluated by receiver operating characteristic curve(ROC).Analyze the relationship between serum CA19-9,CEA,gal-3 levels and clinicopathological features of patients with pancreatic cancer.All patients were followed up after surgery to analyze the relationship between serum CA19-9,CEA,gal-3 levels and prognosis of patients.Results: The levels of SERUM CA19-9,CEA and gal-3 in pancreatic cancer group were higher than those in pancreatitis group(P<0.05).The ROC curve area(AUC) of serum CA19-9,CEA,gal-3 and their combined diagnosis of pancreatic cancer were 0.875,0.764,0.835,and 0.905,respectively, diagnostic specificity of ca19-9,CEA and gal-3 was better than that of serum alone.The levels of SERUM CA19-9,CEA and gal-3 in patients with tumor >3 cm, TNM stage Ⅲand lymph node metastasis were higher than those in patients with tumor ≤3 cm, TNM stage Ⅰ to Ⅱ and no lymph node metastasis(P<0.05).The progression-free survival(PFS) and overall survival(OS) of patients with high serum CA19-9 level were higher than those with low serum CA19-9 level(P<0.05),PFS and OS of patients with high serum CEA level were higher than those with low serum CEA level(P<0.05),PFS and OS of patients with high serum gal-3 level were higher than those with low serum gal-3 level(P<0.05).Conclusion: Serum CA19-9,CEA and gal-3 levels have diagnostic value for pancreatic cancer, and combined detection of the three can improve the diagnostic efficiency, and each index is related to the clinicopathological characteristics and prognosis of patients, and can be used as indicators for diagnosis and prognosis evaluation of patients.