| 曹淑琴,朱朝勇,陈维英,祁永花,张晓媛.胰腺癌患者预后的影响因素及血清CA19-9、CEA对生存结局的预测价值研究[J].,2021,(18):3554-3558 |
| 胰腺癌患者预后的影响因素及血清CA19-9、CEA对生存结局的预测价值研究 |
| Study on the Prognostic Factors of Pancreatic Cancer Patients and the Predictive Value of Serum CA19-9 and CEA on Survival Outcome |
| 投稿时间：2020-12-21 修订日期：2021-01-16 |
| DOI：10.13241/j.cnki.pmb.2021.18.034 |
| 中文关键词: 胰腺癌 糖类抗原19-9 癌胚抗原 预后 生存结局 诊断 |
| 英文关键词: Pancreatic cancer Carbohydrate antigen 19-9 Carcinoembryonic antigen Prognosis Survival outcome Diagnosis |
| 基金项目:青海省卫生计生委指导性科研基金项目（20160318） |
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| 中文摘要: |
| 摘要 目的：探究胰腺癌患者预后的影响因素及血清糖类抗原19-9（CA19-9）、癌胚抗原（CEA）对生存结局的预测价值。方法：选择2010年7月至2016年7月我院诊治的80例胰腺癌患者作为研究对象。采用电化学发光法检测患者的血清CEA和CA19-9水平，采用多因素logistic回归分析影响胰腺癌患者预后的影响因素，采用受试者工作特征（ROC）曲线分析血清CEA和血清CA19-9对胰腺癌患者生存结局的预测价值。结果：单因素分析显示TNM分期、淋巴结转移、治疗方式、血清CEA和血清CA19-9与胰腺癌患者的预后有关（P<0.05）。多因素logistic回归分析则显示非手术治疗、有淋巴结转移、TNM分期Ⅲ～Ⅳ期、血清CEA>5 ng/mL和血清CA19-9>27 U/mL是影响胰腺癌患者预后的危险因素（OR治疗方式 =1.714，OR TNM分期 =2.746, OR血清CEA =1.999, OR血清CA19-9 =2.332, P<0.05）。ROC曲线分析结果显示血清CA19-9检测的曲线下面积（AUC）为0.818，最佳截断值为5.00 ng/mL，灵敏度、特异度分别为0.81、0.86，准确度为0.82；血清CEA检测的AUC为0.788，最佳截断值为27.00 U/mL，灵敏度、特异度分别为0.76、0.83，准确度为0.79；血清CEA联合血清CA19-9检测的AUC为0.910，灵敏度、特异度分别为0.89、0.90，准确度为0.91。结论：非手术治疗、有淋巴结转移、TNM分期Ⅲ～Ⅳ期、血清CEA>5 ng/mL和血清CA19-9>27 U/mL是影响胰腺癌患者预后的危险因素，检测血清CA19-9、CEA可作为预测患者生存结局的重要标记物。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the prognostic factors of pancreatic cancer patients and the predictive value of serum Carbohydrate antigen 19-9 (CA19-9) and Carcinoembryonic antigen (CEA) on survival outcome. Methods: 80 cases of pancreatic cancer patients treated in China Japan Friendship Hospital from July 2010 to July 2016 were selected as subjects. The serum CEA and CA19-9 levels were measured by electrochemiluminescence, the prognostic factors of pancreatic cancer patients were analyzed by multivariate logistic regression, and the predictive value of serum CEA and CA19-9 on the survival outcome of pancreatic cancer patients was analyzed by ROC curve. Results: Univariate analysis showed that TNM stage, tumor differentiation, lymph node metastasis, surgical treatment, serum CEA and serum CA19-9 levels were the prognostic factors of pancreatic cancer patients(P<0.05). Multivariate logistic regression analysis showed that non-surgical treatment, lymph node metastasis, TNM stage III-IV, serum CEA> 5 ng/mL and serum CA19-9 > 27 U/mL were the risk factors for the prognosis of pancreatic cancer patients(OR operation =1.714, OR TNM stage =2.746, OR Serum CEA =1.999, OR Serum CA19-9 =2.332, P<0.05). ROC curve analysis showed that AUC of serum CA19-9 was 0.818, the best cutoff value was 5.00 ng/mL, the sensitivity and specificity were 0.81, 0.86, and the accuracy was 0.82; AUC of serum CEA was 0.788, the best cutoff value was 27.00 U/mL, the sensitivity and specificity were 0.76, 0.83, and the accuracy was 0.79; AUC of serum CEA combined with serum CA19-9 was 0.910 The sensitivity and specificity were 0.89 and 0.90 respectively, and the accuracy was 0.91. Conclusion: Non operative treatment, lymph node metastasis, TNM stage III-IV, serum CEA > 5 ng/mL and serum CA19-9 > 27 μ/mL are the risk factors for the prognosis of pancreatic cancer patients. The detection of serum CA19-9 and CEA can be used as an important marker to predict the survival outcome of patients. |
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