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