血清CEA、CA199、CA242、MUC5AC、KL-6联合检验在胰腺癌辅助诊断中的临床价值

Clinical Value of Combined Detection of Serum CEA,CA199,CA242,MUC5AC,KL-6 in the Auxiliary Diagnosis of Pancreatic Cancer

目的:探讨血清癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原242(CA242)、黏蛋白5AC(MUC5AC)、涎液化糖链抗原(KL-6)联合检测在胰腺癌辅助诊断中的临床价值。方法:选取2021年1月—2023年1月遂平县人民医院收治的48例胰腺癌患者作为观察组,另选48例医院同期健康体检者作为对照组。所有受试者均采血开展CEA、CA199、CA242、MUC5AC、KL-6检测,比较两组CEA、CA199、CA242、MUC5AC、KL-6水平差异情况;依据肿瘤分期分为Ⅰ~Ⅱ期、Ⅲ~Ⅳ期两组,比较两组受试者血清CEA、CA199、CA242、MUC5AC、KL-6水平差异情况;绘制ROC曲线分析CEA、CA199、CA242、MUC5AC、KL-6及联合检测诊断胰腺癌的临床价值。结果:观察组患者血清CEA、CA199、CA242、MUC5AC、KL-6水平高于对照组,差异有统计学意义(t=35.614、70.047、57.885、64.726、57.166,P<0.05);48例胰腺癌患者,其中Ⅰ~Ⅱ期29例,Ⅲ~Ⅳ期19例;Ⅲ~Ⅳ期胰腺癌患者血清CEA、CA199、CA242、MUC5AC、KL-6水平高于Ⅰ~Ⅱ期,差异有统计学意义(t=25.636、37.120、30.494、28.375、19.717,P<0.05);绘制ROC曲线显示,血清CEA、CA199、CA242、MUC5AC、KL-6及联合检测诊断胰腺癌的曲线下面积分别为:0.758、0.771、0.759、0.808、0.820、0.930,联合检测价值最高。结论:血清CEA、CA199、CA242、MUC5AC、KL-6在胰腺癌诊断中具有较高价值,联合检测可进一步提高诊断效能,减少漏诊、误诊发生。

Objective:To explore the clinical value of combined detection of serum carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),carbohydrate antigen 242(CA242),mucin 5AC(MUC5AC)and salivary liquefied carbohydrate chain antigen(KL-6)in the auxiliary diagnosis of pancreatic cancer.Methods:48 patients with pancreatic cancer admitted to the hospital from January 2021 to January 2023 were selected as the observation group,and another 48 patients with physical examination in the same period were selected as the control group.All subjects underwent blood sampling for CEA,CA199,CA242,MUC5AC and KL-6 testing.The differences in CEA,CA199,CA242,MUC5AC and KL-6 levels between the two groups were compared.Patients were divided into two groups based on tumor staging:stage Ⅰ~Ⅱ and stage Ⅲ~Ⅳ,and the differences in serum CEA,CA199,CA242,MUC5AC and KL-6 levels between the two groups were compared.The ROC curve was drawn to analyze the clinical value of CEA,CA199,CA242,MUC5AC,KL-6 and combined detection in the diagnosis of pancreatic cancer.Results:The serum levels of CEA,CA199,CA242,MUC5AC and KL-6 in the observation group were higher than those in the control group,and the difference was statistically significant(t=35.614,70.047,57.885,64.726,57.166;P<0.05).There were 48 cases of pancreatic cancer,including 29 cases of stageⅠ~Ⅱand 19 cases of stageⅢ~Ⅳ.Serum CEA,CA199,CA242,MUC5AC,KL-6 levels and combined diagnosis in patients with stage Ⅲ~Ⅳ pancreatic cancer were higher than those in stage Ⅰ~Ⅱ,and the difference was statistically significant(t=25.636,37.120,30.494,28.375,19.797;P<0.05).ROC showed that the area under the curve of serum CEA,CA199,CA242,MUC5AC,KL-6 and joint detection for diagnosis of pancreatic cancer were 0.758,0.771,0.759,0.808,0.820 and 0.930,respectively,and the joint detection had the highest value.Conclusion:Serum CEA,CA199,CA242,MUC5AC and KL-6 have high value in the diagnosis of pancreatic cancer.Combined detection can further improve the diagnostic efficacy,reduce the incidence of missed diagnosis and misdiagnosis.