CT联合CA199、CA50检测用于胰腺癌诊断的敏感性与特异性探讨

Sensitivity and specificity of CT combined with CA199 and CA50 in the diagnosis of pancreatic cancer

目的探索CT联合糖类抗原199(CA199)、糖类抗原50(CA50)检测胰腺癌诊断的敏感性与特异性。方法选择2018年1月—2021年12月收治的符合入排标准的100例胰腺病变患者,根据病理结果将其分为胰腺癌组53例和良性病变组47例,另选取50例体检健康人群作为对照组。所有入组者均行CT检查并测定其血清CA199及CA50水平,采用Logistics回归模型拟合CT联合CA199、CA50联合诊断模型,绘制ROC曲线,根据ROC曲线分析各指标单独检查及联合检查的诊断价值,明确联合检查用于胰腺癌诊断的敏感性与特异性。结果胰腺癌组CT显示病灶边缘不清、密度不均及变形的发生率明显高于良性病变组及对照组,差异均有统计学意义(P<0.05);胰腺癌组血清CA199及CA50水平明显高于良性病变组及对照组,差异均有统计学意义(P<0.05);CT诊断胰腺癌的敏感性为83.02%,特异性为65.14%,血清CA199诊断胰腺癌的敏感性为66.04%,特异性为63.30%,CA50诊断胰腺癌的敏感性为79.25%,特异性为61.47%,联合诊断的敏感性及特异性分别为92.45%、71.56%,显著高于单独检测;CT、CA199及CA50单独诊断的AUC分别为0.78、0.62、0.75,显著低于联合诊断的AUC(0.88)。结论CT联合CA199、CA50检测用于胰腺癌的诊断,可有效提高检测的敏感性及特异性,明显优于单独检测。

Objective To study the sensitivity and specificity of CT combined with carbohydrate antigen 199(CA199)and carbohydrate antigen 50(CA50)in the diagnosis of pancreatic cancer.Methods From January 2018 to December 2021,100 patients with pancreatic lesions who met the criteria for admission and drainage were divided into the pancreatic cancer group and the benign lesion group according to the pathological results,53 cases and 47 cases respectively.Another 50 healthy people were selected as the control group.All patients were examined by CT and their serum levels of CA199 and CA50 were measured.Logistic regression model was used to fit the combined diagnostic model of CT combined with CA199 and CA50.The ROC curves were drawn.The diagnostic value of each index was analyzed by ROC curves,and to determine the sensitivity and specificity of combined examination in the diagnosis of pancreatic cancer.Results The incidence of unclear margin,uneven density and deformity in the pancreatic cancer group was significantly higher than that in the benign lesion group and the control group(P<0.05).The levels of serum CA199 and CA50 in the pancreatic cancer group were significantly higher than those in the benign lesion group and the control group(P<0.05).The sensitivity and specificity of CT in the diagnosis of pancreatic cancer were 83.02%,65.14%,respectively.The sensitivity and specificity of serum CA199 in the diagnosis of pancreatic cancer were 66.04%,63.30%,respectively,and the sensitivity and specificity of CA50 in the diagnosis of pancreatic cancer were 79.25%,61.47%,respectively,and the sensitivity and specificity of combined diagnosis were 92.45%and 71.56%respectively,which were significantly higher than that of single diagnosis.AUC of CT,CA199 and CA50 were 0.78,0.62 and 0.75 respectively,which were significantly lower than that of combined diagnosis(0.88).Conclusion CT combined with CA199 and CA50 detection in the diagnosis of pancreatic cancer can effectively improve the sensitivity and specificity of the detection,which is obviously superior to the single detection.