吉林大学学报(医学版)

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血清CA199、CA125和CEA联合检测在胰腺癌诊断中的应用

李 静,梁晓芳,翟桂兰   

  1. 辽宁医学院附属第一医院消化科,辽宁 锦州 121001
  • 收稿日期:2014-06-30 出版日期:2014-11-28 发布日期:2015-01-18
  • 通讯作者: 翟桂兰(Tel:0416-4197081,E-mail:zhu66333@163.com) E-mail:zhu66333@163.com
  • 作者简介:李 静(1971-),女,辽宁省黑山县人,教授,主任医师,医学博士,主要从 事肝癌的基因诊断及治疗方面的研究。 
  • 基金资助:

    辽宁省科技厅计划项目资助课题(2013020126-215);辽宁医学院附属第一医院科技启动基金资助课题(FYK201201)

Application of combined detection of serum levels of CA199,
CA125 and CEA in diagnosis of pancreatic cancer

LI Jing,LIANG Xiao-fang,ZHAI Gui-lan    

  1. Department of Gastroenterology,First Affiliated Hospital,Liaoning Medical Un
    iversity,Jinzhou 121001,China
  • Received:2014-06-30 Online:2014-11-28 Published:2015-01-18

摘要:

目的:联合检测不同人群中血清糖蛋白抗原199(CA199)、糖蛋白抗原125(CA125)
和癌胚抗原(CEA)的水平,探讨其对胰腺癌诊断的意义。方法:检测56例胰腺癌患者(胰腺癌组)、56例良性胰腺疾病患者(良性胰腺疾病组)和56 名健康普查者(正常对照组)血清中的肿瘤标志物CA199、CA125和CEA水平,比较各组标志物的阳性率及3种标志物对胰腺癌诊断的敏感性和特异性。结果:胰腺癌组患者血清中CA199、CA125和CEA 的水平明显高于良性胰腺疾病组与正常对照组(P<0.05)。良性胰腺疾病组与正常对照组比较无明显差异。胰腺癌组血清CA199阳性率(87.50%)最高,其次为CEA(71.42%),CA125的阳性率(60.71%)最低。胰腺癌组3种标志物阳性率显著高于良性胰腺疾病组和正常对照组(P<0.05),良性胰腺疾病组与正常对照组比较无明显差异。CA199 的敏感性(87.50%)最高,CEA特异性(91.96%)最高。采用平行联合检测法可提高检测的
敏感性(95.12%) 和阴性预测值(90.47%),但特异性和阳性预测值下降;采用系列联合检测法可提高检测的特异性(92.86%) 和阳性预测值(89.19%),但敏感性和阴性预测值降低。结论:联合检测血清CA199、CA125和CEA的水平较单项检测可提高胰腺癌诊断的敏感性和特异性。

关键词: 胰腺肿瘤, 肿瘤标志物, 糖蛋白抗原199;糖蛋白抗原125;癌胚抗原

Abstract:

Abstract:Objective To detect the serum levels of carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125) and carcino-embryonic antigen(CEA) in different population, and to explore their significances in diagnosis of pancreaticcancer.Methods The serum levels of CA199,CA125 and CEA in 56 patients with pancreatic cancer(pancreatic cancer group),56 patients with benign pancreatic disease(benign pancreatic disease group) and 56 healthy volunteers(normalcontrol group)were detected,then the positive rates of CA199,CA125 and CEA and the sensitivities and specificities of CA199,CEA and CA125 for the diagnosis of pancreatic cancer were compared among three groups.Results The levels of serum CA199,CA125 and CEA of the patients in pancreatic cancer group were significantly higher than those in benign pancreatic disease group and normal control group (P<0.05).The positive rates of CA199,CEA and CA125  in pancreatic cancer group were 87.50 %,71.42%,  and 60.71%,respectively. The  positive rates of the three tumor markers of the patients in pancreatic cancer group were obviously higher than those in other two groups (P<0.05).The sensitivity of CA199(87.50%) was the highest,while the specificity of CEA (91.96%) was the higest.The method of parallel combined testing increased the diagnostic sensitivity to 95.12% and negative predictive value to 90.47%,but its specificity and the positive predictive value were decreased.Serial combined examination increased the diagnostic specificity to 92.86% and the positive predictive value to 89.19%,but its sensitivity and negative predictive value were decreased.Conclusion Combined detection of serum levels of CA199,CA125 and CEA has higher sensitivity and specificity than single-marker detection in the diagnosis of pancreatic cancer.

Key words: pancreatic neoplasms, tumor marker, glycoprotein antigen 199, glycoprotein antigen 125, carcino-embryonic antigen

中图分类号: 

  • R576