| 陈卫红,杨 楷,叶 巍,王文工,许树才.胰腺癌患者血清CEA、CA242、CA199水平变化及联合诊断的ROC曲线分析[J].,2020,(1):144-147 |
| 胰腺癌患者血清CEA、CA242、CA199水平变化及联合诊断的ROC曲线分析 |
| Changes of Serum CEA, CA242 and CA199 Levels in Patients with Pancreatic Cancer and Analysis of ROC Curve for Combined Diagnosis |
| 投稿时间：2019-03-31 修订日期：2019-04-27 |
| DOI：10.13241/j.cnki.pmb.2020.01.032 |
| 中文关键词: 胰腺癌 癌胚抗原 糖类抗原242 糖类抗原199 ROC曲线 联合诊断 |
| 英文关键词: Pancreatic cancer CEA CA242 CA199 ROC curve Combined diagnosis |
| 基金项目:湖北省自然科学基金项目（WJ2019M243） |
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| 中文摘要: |
| 摘要 目的：探讨胰腺癌患者血清癌胚抗原（CEA）、糖类抗原242（CA242）、糖类抗原199（CA199）水平变化，并分析上述指标对胰腺癌的联合诊断价值，为胰腺癌的临床诊断提供参考。方法：选择2014年2月至2018年2月我院收治的186例胰腺癌患者（胰腺癌组）、89例胰腺炎患者（胰腺炎组）作为研究对象，并取同期来我院检查的268例健康人作为对照组。比较三组受试者的血清CEA、CA242、CA199水平变化，对比分析血清CEA、CA242、CA199的单一以及联合诊断的准确度、特异度以及灵敏度，并绘制ROC曲线以分析上述指标的诊断价值。结果：三组受试者血清CEA、CA242、CA199水平差异具有统计学意义（P<0.05）。且胰腺炎组和胰腺癌组的血清CEA、CA242、CA199水平明显高于对照组，胰腺癌组患者的血清CEA、CA242、CA199水平明显高于胰腺炎组，差异均有统计学意义（P<0.05）。ROC曲线结果显示，CEA诊断价值最大，CA199诊断价值最小。CEA是胰腺癌单项肿瘤标志物中敏感度最高的，为85.48%；特异度最高的为CA242（96.72%）；三项肿瘤标志物联合诊断的准确度增加至92.27%，敏感度增加至95.16%，特异度相比略有下降。结论：与单一肿瘤标记物诊断胰腺癌相比，CEA、CA242、CA199联合诊断的敏感度和准确度均明显升高，可以明显改善胰腺癌的漏诊率，提高患者的生存率，具有较好的临床应用价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the changes of serum carcinoembryonic antigen (CEA), carbohydrate antigen 242 (CA242) and carbohydrate antigen 199 (CA199) levels in patients with pancreatic cancer, and to analyze the combined diagnostic value of the above indicators for pancreatic cancer, so as to provide reference for clinical diagnosis of pancreatic cancer. Methods: 186 patients with pancreatic cancer (pancreatic cancer group) and 89 patients with pancreatitis (pancreatitis group) admitted to our hospital from February 2014 to February 2018 were selected as the study subjects, and 268 healthy persons who came to our hospital for examination during the same period were selected as the control group. The changes of serum CEA, CA242 and CA199 levels were compared among the three groups. The accuracy, specificity and sensitivity of single and combined diagnosis of serum CEA, CA242 and CA199 were compared and analyzed. The ROC curve was drawn to analyze the diagnostic value of the above indicators. Results: There were significant differences in serum CEA, CA242 and CA199 levels among the three groups (P<0.05). The levels of serum CEA, CA242 and CA199 in pancreatitis group and pancreatic cancer group were significantly higher than those in control group. The levels of serum CEA, CA242 and CA199 in pancreatic cancer group were significantly higher than those in pancreatitis group (P<0.05). ROC curve showed that CEA had the greatest diagnostic value and CA199 had the smallest diagnostic value. CEA was the most sensitive single tumor marker for pancreatic cancer (85.48%), CA242 (96.72%) had the highest specificity; the accuracy of combined diagnosis of three tumor markers increased to 92.27%, the sensitivity increased to 95.16%, and the specificity decreased slightly. Conclusion: Compared with single tumor marker in the diagnosis of pancreatic cancer, the sensitivity and accuracy of CEA, CA242 and CA199 combined diagnosis were significantly increased, which could significantly improve the missed diagnosis rate of pancreatic cancer, improve the survival rate of patients, and have better clinical application value. |
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