| Objective:investigate the clinical value of combined test of serum CA19-9, CA50 and CEA levels in the diagnosis of patientswith pancreatic cancerMethords:Retrospective analysis of 75 patients with pancreatic cancer,69 patients with chronic pancreatitis and 71 healthy patients with serum CEA, CA199 and CA50 levels, Packet Statistics tumor markers in each group the sensitivity, specificity, positive predictive value, negative predictive value, Accuracy, Comparison of the expression results, the best expression of selected markers, calculation of individual tumor markers positive rate and two, three tumor markers positive rate; Comparison of patients with pancreatic cancer serum Ca199, Ca50, CEA and tumor location, size, TNM stage and resectability relationship.Results:Normal serum CA19-9, CA50, CEA level is low; Benign pancreatic diseases group CA19-9, CA50 higher than the normal range, but compared with the normal group was no significant difference Patients with pancreatic cancer serum CA19-9, CA50, CEA level was significantly increased, With the normal group and benign pancreatic disease group, there are significant differences(P<0.05或P<0.01)。CA19-9, CA50 and CEA for the diagnosis of pancreatic cancer as the three indicators as the critical upper limit of normal, less than the critical value is negative, greater than or equal to the critical value of positive。Calculate the sensitivity, specificity, CA19-9 can be seen that the sensitivity and specificity of the highest, Were 82.7% and 80.7%。Therefore, the diagnosis of pancreatic cancer the highest CA19-9, CA50, CEA is relatively poor。If the test associated with the parallel detection method, that is, any one of the three indicators is greater than or equal to the critical value is positive, can improve the detection sensitivity (86.7%) and negative predictive value (88.9%), but specificity and positive predictive value decreased; On the contrary, the use of a series of tests that meet three criteria must all be considered greater than or equal to the critical value is positive, then improve the detection specificity (87.9%) and positive predictive value (70.7%), reduced sensitivity and negative predictive value. 2.2 Tumor markers positive rate Determination of single tumor marker low positive rate of pancreatic cancer, CA50-positive rate was the highest reached 85.4%; and the lowest positive rate of CEA, only 43.9 percent. Single tumor marker of pancreatic cancer group the positive rate was significantly higher than the detection of chronic pancreatitis group, the differences were significant (P<0.05). Determination of the two tumor markers, the positive rate than the individual determination of tumor markers increased, but the combination of three tumor markers were determined after the results have the positive rate increased from 82.9% increased to 95.1%, the difference There was a significant (P<0.05). 2.3 Serum CEA, CA199 and CA50 in pancreatic cancer location, size, TNM stage and resectability of the relationship between CA199 in pancreatic cancer patients was significantly higher than the expression of pancreatic cancer patients (P=0.045).Levels of CEA and CA50 no significant correlation between tumor location (P> 0.05). The value of CA19-9 in stageⅡ,Ⅲperiod,Ⅳstage was 880.97±2225.66,1006.62±1515.88,3050.59±3886.73; CA50 in the period corresponding to 110.29±49.33,141.5±25.6,183.28±51.83; CEA were 13.42±17.58,12.46±30.26,91.54±238.78.Serum levels of tumor markers in the relationship between stages of pancreatic cancer with the progression of pancreatic cancer, CA19-9, CA50 and CEA gradually increased the expression of the trend.Ⅳserum of patients with pancreatic cancer CEA, CA199 and CA50ⅡandⅢwere significantly higher than that of patients with pancreatic cancer (P<0.05). CEA, CA199 and CA50 levels were not tumor size and resectability of (P> 0.05)。Conclusion:Combined detection of CA199, CA50 and CEA can significantly improve the diagnosis of pancreatic cancer, pancreatic cancer diagnosis is an ideal target. |
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