The Value Of TAP Combined With CA19-9 In The Diagnosis Of Pancreatic Cancer

Purpose:Pancreatic cancer has become the 4th leading cause of cancer-related deaths in the United States,and in the past decade,the proportion of pancreatic cancer-related deaths in China has increased by 9%.The pancreas is a retroperitoneal organ,and its position in the abdominal cavity is deep,and the early symptoms are not specific.About80%of the patients are diagnosed in the late stage.Therefore,it is urgent to improve the early diagnosis rate of pancreatic cancer.The purpose of this study was to analyze the differential expression and diagnostic efficacy of a new tumor marker-tumor abnormal protein(Tumor Abnormal Protein,TAP)in pancreatic benign tumors and its correlation with the clinical features of pancreatic cancer,and to evaluate the advantages and disadvantages of combined diagnosis with traditional tumor markers-CA19-9,CEA and CA125,so as to provide a theoretical basis for the clinical application of TAP in the diagnosis of pancreatic diseases.In order to explore the clinical value of TAP as a diagnostic marker of pancreatic cancer.Method:The clinical data of 78 patients with pancreatic tumor treated in the First Affiliated Hospital of Dalian Medical University from January 2019 to January 2021 were collected.According to postoperative pathology,the patients were divided into benign pancreatic tumor group(n=31)and pancreatic ductal adenocarcinoma group(n=47).There are no limit on the sex and age of the patients,and TAP,CA19-9,CEA and CA125were detected before operation.TAP>121μm~2,CA19-9>27U/ml,CEA>5ng/ml,CA125>35U/ml were regarded as positive.Statistical analysis was carried out by SPSS26.0 software.The measurement data were expressed by mean±standard deviation(X±SD).Independent sample t-test was used to compare normal distribution between the two groups,and chi-square test was used for correlation analysis.The efficacy of TAP,CA19-9,CEA,CA125 and CA199 combined with TAP,CA19-9 combined with CEA and CA19-9 combined with CA125 in the diagnosis of pancreatic cancer was analyzed by(ROC)and the area under the curve was calculated.P<0.05 is defined as statistical difference.Result:1.The difference of TAP between pancreatic cancer and benign tumor:the expression of TAP in peripheral blood of patients with pancreatic cancer(136.357±47.526μm~2)was significantly higher than that of patients with pancreatic benign tumor(105.388±34.992μm~2).2.In terms of diagnostic value of pancreatic cancer,(1)the sensitivity,specificity and Jordan index of CA19-9 were 85.10%,87.10%and 72.20%,respectively;(2)the sensitivity and specificity of CEA and Jordan index were 29.80%,96.80%and 26.60%,respectively;(3)the sensitivity,specificity and Jordan index of CA125 were 21.30%,96.80%and 18.10%,respectively.(4)the sensitivity,specificity and Yoden index of TAP are 70.20%,67.70%and 37.90%,respectively.(5)the AUC of CA19-9,CEA,CA125 and TAP were 0.857,0.775,0.702 and 7 0.706,respectively.3.In terms of joint diagnostic efficacy,(1)the sensitivity,specificity and Jordan index of CA19-9 combined with TAP in the diagnosis of pancreatic cancer were 93.60%,67.70%and 61.30%,respectively;(2)the sensitivity,specificity and Jordan index of CA19-9combined with CA125 in the diagnosis of pancreatic adenocarcinoma were 85.10%,87.10%and 72.20%,respectively.(3)the sensitivity,specificity and Yoden index of CA19-9 combined with CEA in the diagnosis of pancreatic cancer were 89.40%,87.10%and 76.50%,respectively.(4)the AUC of CA19-9 with TAP,CA19-9 with CA125 and CA19-9 with CEA was 0.883,0.858 and 0.879 respectively.Conclusion:The expression of TAP in peripheral blood of patients with pancreatic cancer is significantly higher than that of patients with pancreatic benign tumor,which has a good value in the diagnosis of pancreatic cancer.The sensitivity and specificity of TAP combined with CA19-9 in the diagnosis of pancreatic cancer was higher than that of TAP or CA19-9 alone in the diagnosis of pancreatic cancer.