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目的 评价血清肿瘤标志物单项检测和联合检测对胰腺癌诊断的意义。方法 对 10例慢性胰腺炎和 5 1例胰腺癌病人用放免法测定血清CA199,CA5 0 ,CA12 5和CEA含量 ,分析并比较单项检测和联合检测的意义。结果 4种肿瘤标志物单项检测以CA199对胰腺癌诊断意义最大 ,敏感性和特异性最好 ,分别达 92 5 %和 81 81% ,误检率 18 18% ,漏检率 7 5 % ,阳性预测值94 87% ,阴性预测值 75 % ,研究还发现CA199特别对早期胰体癌诊断有较大意义 ;联合检测以CA199+x(CA5 0 ,CA12 5 ,CEA任一阳性 )意义较大 ,敏感性 87 5 % ,特异性 81 81% ,误检率 18 18% ,漏检率 12 5 % ,阳性预测值 94 5 9% ,阴性预测值 6 4 2 8% ;但诊断价值不大于CA199单项检测 (P >0 0 5 )。结论 CA199检测对胰腺癌诊断意义较大 ,特别对早期胰体癌诊断有较大意义 ;联合检测并不能提高CA199的诊断价值 ,却增加医疗费用 ,意义不大
Objective To evaluate the significance of single detection and combined detection of serum tumor markers in the diagnosis of pancreatic cancer. Methods The serum levels of CA199, CA5 0, CA12 5 and CEA in 10 cases of chronic pancreatitis and 51 cases of pancreatic cancer were measured by radioimmunoassay. The significance of single detection and combined detection was analyzed and compared. RESULTS: The four tumor markers detected by CA199 had the greatest significance for the diagnosis of pancreatic cancer with the highest sensitivity and specificity of 92.5% and 81.81% respectively. The false positive rate was 18 18%, and the missed rate was 75%. The predicted value was 94 87% and the negative predictive value was 75%. The study also found that CA199 was particularly significant for the diagnosis of early pancreatic cancer, and the combined detection of CA199+x (CA5 0, CA12 5, CEA, any positive) was significant. Sensitivity 87 5 %, specificity 81 81%, false detection rate 18 18%, missed detection rate 12 5 %, positive predictive value 94 5 9%, negative predictive value 6 4 2 8%; but the diagnostic value is not greater than CA199 Detection (P > 0 0 5). Conclusion The CA199 test has great significance in the diagnosis of pancreatic cancer, especially for the diagnosis of early pancreatic cancer. Combined detection does not improve the diagnostic value of CA199, but it increases the cost of medical care.