论文部分内容阅读
目的评价4种血清肿瘤标志物在胰腺占位良恶性鉴别诊断中作用的大小。方法运用ROC(receiver-operating characteristics)曲线法对173例胰腺癌病人和71例胰腺良性疾病病人的血清学糖类抗原CA_(19-9)、CA_(242)、CA_(50)和癌胚抗原(CEA)4种肿瘤标志物检测结果进行分析,同时对结果进行统计学检验。结果单项肿瘤标志物检测,4种肿瘤标志物的水平在胰腺癌组均高于良性胰腺疾病组,且差异均有显著性意义(P<0.001)。同时分别计算各个肿瘤标志物的特异性、敏感性、阳性似然比和阴性似然比。CA_(19-9)敏感性和阴性似然比最好,分别为77.46%和0.3138,CA_(50)特异性和阳性似然比最好,分别为94.37%和6.2629。然后运用ROC曲线法对4种肿瘤标志物的检测结果进行处理。4种肿瘤标志物糖类抗原CA_(19-9)、CA_(242)、CA_(50)和癌胚抗原(CEA)的AUC分别为0.812、0.760、0.756和0.741。通过分层分析,CA_(19-9)和CA_(242)在手术无法切除组高于手术可切除组。处理结果统计学均有显著性意义(P<0.001)。结论CA_(19-9)等4种血清肿瘤标志物对鉴别胰腺占位良恶性均有一定的临床意义,其中CA_(19-9)的综合诊断能力较强。
Objective To evaluate the role of four serum tumor markers in differential diagnosis of benign and malignant pancreatic masses. Methods Serological carbohydrate antigens CA 19-9, CA 242, CA 50 and carcinoembryonic antigen in 173 patients with pancreatic cancer and 71 patients with pancreatic benign disease were analyzed by receiver-operating characteristics (ROC) curve. (CEA) four kinds of tumor markers test results were analyzed, and the results were statistically tested. Results The detection of single tumor markers showed that the levels of four tumor markers in pancreatic cancer group were higher than those in benign pancreatic disease group, and the difference was significant (P <0.001). At the same time, the specificity, sensitivity, positive likelihood ratio and negative likelihood ratio of each tumor marker were calculated respectively. The sensitivity and negative likelihood ratios of CA 19-19 were the best, 77.46% and 0.3138 respectively, and the specificity of CA 50 and the positive likelihood ratios were 94.37% and 6.2629, respectively. Then using the ROC curve method to test the results of four kinds of tumor markers. The AUC of the four tumor markers carbohydrate antigen CA_ (19-9), CA_ (242), CA_ (50) and carcinoembryonic antigen (CEA) were 0.812, 0.760, 0.756 and 0.741, respectively. By stratified analysis, CA_ (19-9) and CA_ (242) were higher in unresectable group than those in surgically resectable group. Statistical analysis of the results were statistically significant (P <0.001). Conclusions Four kinds of serum tumor markers, such as CA 19-9, have some clinical significance in differentiating benign and malignant pancreatic masses. Among them, CA 19-9 has a high comprehensive diagnostic ability.