血清CA199、C3、C4及脂类代谢水平在胰腺癌临床诊断中的应用

doi:10.13481/j.1671-587x.20160220

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (02): 295-300.doi: 10.13481/j.1671-587x.20160220

血清CA199、C3、C4及脂类代谢水平在胰腺癌临床诊断中的应用

张宁^1,2, 王颖娴¹, 胡健¹, 郑婕³, 王晓琴¹

1. 西安交通大学第一附属医院检验科, 陕西西安 710061;
2. 西安交通大学医学部, 陕西西安 710061;
3. 西安交通大学第一附属医院临床研究中心, 陕西西安 710061

收稿日期:2015-07-11 发布日期:2016-03-31
通讯作者: 王晓琴,副主任技师,硕士研究生导师(Tel:029-85323648,E-mail:1493722680@qq.com) E-mail:1493722680@qq.com
作者简介:张宁(1987-),女,陕西省西安市人,检验技师,医学硕士,主要从事肿瘤免疫学方面的研究。
基金资助:
国家自然科学基金面上项目资助课题(81472822);陕西省国际科技合作与交流计划资助课题(2015KW-045)

Application of levels of serum CA199, C3, C4 and lipid metabolism in clinical diagnosis of pancreatic cancer

ZHANG Ning^1,2, WANG Yingxian¹, HU Jian¹, ZHENG Jie³, WANG Xiaoqin¹

1. Department of Clinical Laboratory, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China;
2. Health Science Center, Xi'an Jiaotong University, Xi'an 710061, China;
3. Clinical Research Center, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China

Received:2015-07-11 Published:2016-03-31

摘要/Abstract

摘要：

目的: 评估单独及联合检测血清CA199、补体3(C3)、补体4(C4)、总胆固醇(TC)和脂类代谢水平在胰腺癌临床诊断中的应用价值,并探讨上述指标与胰腺癌TNM分期及病理分期的关系。方法: 收集77例胰腺癌患者(Pc组)、58例非消化系统肿瘤患者(Ndc组)和50名健康对照者(Hc组)共185例血清,测定各组受试者血清CA199、C3、C4以及甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)、载脂蛋白E(ApoE)和脂蛋白a[Lp(a)]等脂代谢水平,并对结果进行统计分析。结果: ①Pc组患者血清CA199水平显著高于Ndc组和Hc组(P<0.01),而Ndc组与Hc组比较差异无统计学意义(P>0.05);Pc组和Ndc组患者血清C3、C4及ApoE水平显著高于Hc组(P<0.01),且Pc组显著高于Ndc组(P<0.01);Pc组患者血清HDL-C、ApoA和Lp(a)水平低于Ndc组和Hc组(P<0.05)。②Pc组患者血清CA199、C3、C4、ApoE、HDL-C、ApoA受试者工作特征曲线(ROC)下面积(AUC)分别为0.916、0.841、0.788、0.785、0.834和0.810,对胰腺癌均具有一定诊断价值;多因素联合分析,联合检测血清CA199、C3和HDL-C(AUC=0.968)较单独检测CA199具有更高的诊断价值(P<0.05)。③TNM分期,Ⅲ-Ⅳ期胰腺癌患者血清CA199水平显著高于Ⅰ-Ⅱ期患者(P<0.01);而病理分期中高分化组患者血清ApoA水平明显低于低分化组患者(P<0.05),其他指标比较差异无统计学意义(P>0.05)。结论: 胰腺癌患者血清CA199、C3、C4及ApoE水平明显升高,而HDL-C、ApoA以及Lp(a)水平明显降低;在胰腺癌早期诊断中,联合检测血清CA199、C3和HDL-C优于各指标单项评估。

关键词: 胰腺肿瘤, CA199, 补体, 脂代谢, 受试者工作特征曲线, 肿瘤分期

Abstract:

Objective: To evaluate the diagnostic values of single and combined detection of serum CA199, complement 3 (C3), complement 4 (C4), total cholesterol (TC), triglyceride (TG), and lipid metabolism levels in the patients with pancreatic cancer, and to explore their correlations with TNM stage and pathological stage of pancreatic cancer.Methods: Total 185 subjects were enrolled into the study by three groups:pancreatic cancer patients group(Pc group, n=77), non-digestive system cancer patients group (Ndc group, n=58) and healthy control group (Hc group, n=50).The levels of serum CA199, C3, C4, and high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol(LDL-C), apolipoprotein A (ApoA), apolipoprotein B (ApoB), apolipoprotein E (ApoE), and lipoprotein a (Lpa) levels were detected.Results: ① The serum level of CA199, C3, C4, and ApoE of the patients in Pc group were higher than those in Ndc and Hc groups (P<0.01).No statistical difference was observed in the serum CA199 between Ndc and Hc groups(P>0.05). The levels of C3, C4, and ApoE in Pc group and Ndc group was higher than those in Hc group (P<0.01), and the levels of the biomarkers in Pc group were also higher than those in Ndc group (P<0.01).The levels of HDL-C, ApoA and Lp(a) of the patients in Pc group were significantly lower than those in Ndc and Hc groups (P<0.05).② The area under ROC curve (AUC) of serum CA199, C3, C4, ApoE, HDL-C, and ApoA were 0.916, 0.841, 0.788, 0.785, 0.834, and 0.810, respectively.Furthermore, multiple factor analysis showed that the combined detection of CA199, C3, and HDL-C (AUC=0.968) improved the diagnosis compared with detecting CA199 alone (P<0.05).① The CA199 level of the patients in Ⅲ-Ⅳ stage of TNM stage was higher than that in the patients in Ⅰ-Ⅱ stage (P<0.01).For the pathological stage, the ApoA level in low differentiation group was higher than that in moderate and high differentiation group (P<0.05).There was no statistical difference in other biomarkers between the different TNM stages and pathological stages.Conclusion: The levels of CA199, C3, C4 and ApoE of pancreatic cancer patients are significantly increased, while the levels of HDL-C, ApoA, and Lp (a) are significantly reduced.Combined detection of CA199, C3, and HDL-C can improve the early diagnosis of pancreatic cancer compared with the single assessment of each biomarker.

Key words: pancreas neoplasms, CA199, complement, lipid metabolism, receiver operating characteristic curve, tumor stage

中图分类号:

R733.3

张宁, 王颖娴, 胡健, 郑婕, 王晓琴. 血清CA199、C3、C4及脂类代谢水平在胰腺癌临床诊断中的应用[J]. 吉林大学学报(医学版), 2016, 42(02): 295-300.

ZHANG Ning, WANG Yingxian, HU Jian, ZHENG Jie, WANG Xiaoqin. Application of levels of serum CA199, C3, C4 and lipid metabolism in clinical diagnosis of pancreatic cancer[J]. Journal of Jilin University Medicine Edition, 2016, 42(02): 295-300.

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血清CA199、C3、C4及脂类代谢水平在胰腺癌临床诊断中的应用

Application of levels of serum CA199, C3, C4 and lipid metabolism in clinical diagnosis of pancreatic cancer

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