CA19-9、CEA、CA125联合应用对早期胰腺导管腺癌诊断和预后评估的价值

叶斯斯; 张婷婷; 苏丹; 隋丽丽; 白莉

doi:10.3969/j.issn.2095-5227.2015.12.010

CA19-9、CEA、CA125联合应用对早期胰腺导管腺癌诊断和预后评估的价值

Prognostic and predictive value of serum tumor markers in early stage of pancreatic ductal adenocarcinoma

摘要

摘要: 目的探讨血清肿瘤标记物糖类抗原19-9(carbohydrate antigen 19-9，CA19-9)、癌胚抗原(carcinoembryonic antigen，CEA)、糖类抗原125(carbohydrate antigen 125，CA125)在早期胰腺导管腺癌(pancreatic ductal adenocarcinoma，PDAC)诊断和预后评估中的临床应用价值。方法收集2006年1月- 2013年7月确诊为PDAC(Ia ～Ⅱb期)并有术前血清CA19-9、CEA、CA125检测的307例患者的病历资料，并与200例胰腺良性病变和100例健康体检者比较。同时根据早期PDAC患者术前不同的血清肿瘤标记物水平，分成不同的亚组进行比较。采用回顾性统计方法分析血清肿瘤标记物CA19-9、CEA、CA125对早期PDAC的诊断和预后评估价值。结果早期PDAC患者血清CA19-9、CEA、CA125水平明显高于胰腺良性病变组和健康对照组(P< 0.01)。CA19-9、CEA、CA125联合检测诊断早期PDAC的对应的曲线下面积0.923，敏感性、准确性分别为89.6%、85.7%，与各单项检测比较差异有统计学意义(P< 0.01)。合并不同术前CA19-9和CEA水平的早期PDAC患者，在肿瘤位置、分化程度、最大直径、T分期、临床分期、有无淋巴结转移、有无十二指肠侵犯、中位生存期长短等方面的差异有统计学意义(P< 0.05)。结论血清肿瘤标记物CA19-9、CEA、CA125水平可作为早期PDAC的诊断的辅助指标，三项联合检测对提高诊断早期PDAC的敏感性及准确性和预后评估有很重要的临床指导意义。

Abstract: Objective To assess the diagnostic and prognostic value of combined detection of carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) for patients with resectable pancreatic ductal adenocarcinoma (PDAC)． Methods A total of three hundred and seven patients with resectable PDAC admitted to Chinese PLA General Hospital from January 2006 to July 2013 were enrolled, and two hundred patients with pancreatic benign lesions and one hundred healthy subjects were served as controls． Then patients were stratified into subgroups in regard to their preoperative tumor marker levels． Retrospective analysis was utilized to identify diagnostic and prognostic value of the combined detection of CA19-9, CEA and CA125 for patients with resectable PDAC． Results The preoperative serum level of CA19-9, CEA and CA125 in patients with early stage of PDAC was found to be significantly higher than those with benign pancreatic diseases and healthy controls (P< 0．01)． The combined detection of CA19-9, CEA and CA125 yielded a ROC value of 0．923 that was obviously higher compared to any of single detection (P< 0．01), and its sensitivity and accuracy were 89．6% and 85．7%, respectively． The combination of preoperative CA19-9 and CEA levels in patients with resectable PDAC had close correlation with tumor location, the degree of tumor differentiation, tumor size, T stage, lymph node involvement, duodenum invasion and overall survival (P< 0．05)． Conclusion The combined detection of serum tumor markers CA19-9, CEA and CA125 can improve diagnostic rate and provide useful information to estimate prognosis in patients with resectable PDAC．

HTML全文

参考文献(0)

施引文献

资源附件(0)