肿瘤标志物血清miR-429、CEA、AFF3、CA199联合诊断胰腺癌的价值

The Value of Tumor Marker Serum miR-429,CEA,AFF3,CA199 in the Diagnosis of Pancreatic Cancer

目的探讨与分析肿瘤标志物血清miR-429、癌胚抗原(CEA)、AFF3、糖类抗原199(CA199)联合诊断胰腺癌的价值。方法选取2018年8月—2022年12月在内蒙古自治区精神卫生中心接受检验的105例胰腺癌患者作为胰腺癌组,同期选取在内蒙古自治区精神卫生中心接受检验的105例胰腺良性结节作为良性组。检测胰腺癌组与良性组的血清miR-429、CEA、AFF3、CA199水平,判断阳性率与诊断价值。结果胰腺癌组的血清CEA、AFF3、CA199含量显著高于良性组(P<0.05),血清miR-429相对表达水平与良性组相比也显著增加(P<0.05)。胰腺癌组的血清miR-429、CEA、AFF3、CA199表达阳性率为74.29%、80.00%、84.76%、90.48%,显著高于良性组的4.76%、5.71%、3.81%、6.67%(P<0.05)。在胰腺癌210例患者中,Pearson相关分析显示血清miR-429、CEA、AFF3、CA199表达水平与组织学分化、临床分期、淋巴结转移等存在相关性(P<0.05)。肿瘤标志物血清miR-429、CEA、AFF3、CA199判断为胰腺癌104例,肿瘤标志物血清miR-429、CEA、AFF3、CA199鉴别诊断胰腺癌的敏感性与特异性分别为98.10%(103/105)、99.05%(104/105),阳性预测值为99.04%(103/104),阴性预测值为98.11%(104/106)。受试者操作特征(ROC)曲线分析显示肿瘤标志物血清miR-429、CEA、AFF3、CA199联合诊断胰腺癌的最大曲线下面积为0.920,Kappa检验分析联合诊断的一致性为0.874。结论胰腺癌多伴随有血清miR-429、CEA、AFF3、CA199的高表达,与患者的病理特征存在相关性,肿瘤标志物血清miR-429、CEA、AFF3、CA199联合诊断胰腺癌具有很高的敏感度与特异度。

Objective To explore and analysis the values of combined diagnosis of tumor markers serum miR-429,CEA,AFF3,CA199 in pancreatic cancer.Methods From August 2018 to December 2022,105 cases of patients with pancreatic cancer diagnosed and treated in Inner Mongolia Autonomous Region Mental Health Center were selected as the pancreatic cancer group,and 105 cases of patients with benign pancreatic nodules diagnosed and treated in th same hospital were selected as the benign group at the same time.The levels of serum miR-429,CEA,AFF3,and CA199 in both groups were detected.And the positive rate was calculated and diagnostic values were evaluated.Results The levels of serum CEA,AFF3,CA199 in the pancreatic cancer group were signifi cantly higher than those in the control group(P<0.05),and the relative expression level of serum miR-429 was also signifi cantly higher than that in the control group(P<0.05).The positive rates of serum miR-429,CEA,AFF3,CA199 expression in pancreatic cancer group were 74.29%,80.00%,84.76%,90.48%,signifi cantly higher than 4.76%,5.71%,3.81%,6.67%in the control group(P<0.05).In the 210 patients with pancreatic cancer,the expression levels of serum miR-429,CEA,AFF3 and CA199 were correlated with histological diff erentiation,clinical stage and lymph node metastasis(P<0.05).There were 104 cases of pancreatic cancer were diagnosed by tumor marker serum miR-429,CEA,AFF3 and CA199.The sensitivity and specifi city of tumor marker serum miR-429,CEA,AFF3 and CA199 in diff erential diagnosis of pancreatic cancer were 98.10%(103/105)and 99.05%(104/105)respectively.The positive predictive value were 99.04%(103/104),and the negative predictive value were 98.11%(104/106).ROC analysis showed that the maximum area under the curve of serum miR-429,CEA,AFF3,CA199 combined diagnosis of pancreatic cancer was 0.920,and the consistency of Kappa test on the tumor markers combined diagnosis was 0.874.Conclusion High expression of serum miR-429,CEA,AFF3,CA199 is often associated with pancreatic cancer,which is related to the pathological characteristics of patients.The combination of serum miR-429,CEA,AFF3,CA199 has relatively high sensitivity and specifi city in the diagnosis of pancreatic cancer.