晚期胰腺癌患者血清CA125,CA199水平与肝转移的关系

目的分析晚期胰腺癌患者血清CEA,CA199水平与肝转移的关系,探讨胰腺癌肝转移的危险因素。方法选取101例胰腺癌患者,主要根据有无肝转移分组,肝转移70例,无肝转移31例。采用化学发光免疫法对其血清标本中癌胚抗原(CEA)、糖抗原19-9(CA19-9)、糖抗原125(CA125)、糖抗原72-4(CA72-4)、细胞角蛋白21-1(CYFRA21-1)等项目进行检测。结果血清CA19-9、CA125水平的增高与胰腺癌肝转移具有相关性(P0.05)。结论血清CA19-9、CA125水平的升高与胰腺癌肝转移有着一定相关性,是胰腺癌肝转移的危险因素。CA125升高(OS5.10个月vs10.87个月,P=0.005)、CA19-9≥1 000U/mL(OS 5.13个月vs 8.53个月,P=0.003)与转移性胰腺癌不良预后相关。     

血清CA19-9、CEA水平与胰腺癌预后的关系

目的：探讨胰腺癌患者术前血清中CA19-9与CEA表达情况对预后的影响。方法：回顾分析医院2012年1月～2013年12月128例胰腺癌患者临床病理资料,应用Kaplan．Meier法、Log—rank检验及Cox回归分析CA19-9和CEA水平与患者生存时间的关系。血清中CA19-9〉39U／mL,CEA〉4．7ng／mL被视为表达增高。结果：128例患者平均年龄为62岁,中位生存期为12．2月,其中CA19—9和CEA的表达水平增高的比例分别为78．1％,37．5％。CA19-9、CEA升高组患者的预后明显差于正常组（CA19-9,P=0．027;CEA,P=0．036）。Cox多因素回归分析显示淋巴结转移、CA19—9〉39U／mL、CEA〉4．7ng／mL是影响胰腺癌患者预后的独立因素。结论：术前CA19-9、CEA水平与胰腺患者生存时间密切相关,能有效评估患者的预后。     

单羧酸转运蛋白4在胰腺癌中的表达及临床预后价值

目的：分析单羧酸转运蛋白4(Monocarboxylate Transporter 4,MCT4)在胰腺癌组织中的表达分布与水平及其预后预测价值。方法:回顾性分析2010年2月至2014年6月期间在复旦大学附属肿瘤医院胰腺肿瘤研究所接受根治性手术切除的379例胰腺癌患者的临床资料。运用免疫组化染色检测MCT4蛋白在胰腺癌组织中的表达,分析其与患者临床病理特征的关系。采用Kaplan-Meier生存曲线和多因素Cox回归分析模型分析MCT4蛋白对患者预后的预测价值。结果：胰腺癌组织中MCT4阳性表达患者的肿瘤直径更大(P = 0.004),更容易出现淋巴结转移(P = 0.005),TNM分期也更高(P = 0.011)。MCT4阳性表达患者的中位总生存时间(overall survival, OS,12.4个月)和无复发生存时间(recurrence-free survival, RFS,7.3个月)均显著短于MCT4阴性表达患者(21.3个月,P < 0.001和11.4个月, P < 0.001)。多因素Cox回归分析显示,胰腺癌组织中MCT4阳性表达是胰腺癌患者术后OS(风险比=1.814,95%置信区间1.433~2.296,P < 0.001)和RFS(风险比：1.648,95%置信区间1.319~2.059,P < 0.001)短的独立预测因子。结论：胰腺癌组织MCT4蛋白阳性表达是胰腺癌患者术后预后不良的独立预测因子,可成为筛选术后高危人群的重要指标以及潜在的治疗靶点。     

血清肿瘤标志物CA19—9在胰腺癌诊断和预后中的价值

目的探讨检测血清肿瘤标志物癌抗原19—9（CA19—9）在胰腺癌诊断和预后中的作用。方法回顾性分析了105例胰腺癌患者、70例非胰腺外分泌恶性肿瘤患者以及30例胰腺良性疾病患者术前血清CA19—9的水平。结果血清CA19—9在胰腺癌患者中的表达水平显著高于胰岛细胞瘤、壶腹癌以及良性胰腺疾病患者（P〈0．05），而与肝外胆管癌患者的CA19—9水平无显著差异（P〉0．05）。CA19—9对胰腺癌诊断的敏感性和特异性分别为80％和43％。CA19—9在胰体尾癌患者中的表达水平显著高于胰头癌患者（P〉0．05）。CA19—9不受肿瘤大小以及可切除性的影响（P〉0．05），但在Ⅳ期胰腺癌患者中明显提高（P〈0．05）。结论CA19—9对胰腺癌的诊断具有一定的作用，但特异性不高，高水平的CA19—9提示病期较晚，预后不良。     

构建癌胚抗原、糖类抗原19-9生存模型公式预测结直肠癌患者生存时间

目的 构建术前癌胚抗原(CEA)、糖类抗原19-9(CA19-9)模型,预测结直肠癌(CRC)患者的生存时间。方法 收集江门市中心医院就诊的313例CRC患者,利用Beckman Access化学发光免疫分析仪检测CRC患者术前血清CEA、CA19-9水平,运用χ²检验评估其与CRC患者临床病理参数的关系,Kaplan-Meier生存分析和Cox多因素分析分别评估CRC患者生存及预后。结果 CEA、CA19-9均与CRC患者pT、pN、pM分期,临床Ⅰ、Ⅱ、Ⅲ、Ⅳ分期,进展,复发,脉管浸润,转移部位等因素相关(P<0.05)。CEA升高患者的总生存时间(OS)较CEA正常患者缩短(76.85个月vs 110.83个月,P=0.000)。CA19-9升高患者的OS也有相同趋势(P=0.000)。Cox多因素分析发现CEA、CA19-9是预测CRC患者生存的独立因素(HR分别为2.190和2.874;95%CI分别为1.486～3.225和1.947～4.242;P均<0.05)。联合CEA、CA19-9构建模型公式,赋予CEA正常为0分,CEA升高为1分...     

血清糖类抗原CA125和CA19-9对鉴别卵巢交界性肿瘤及上皮性卵巢癌的价值

目的探讨血清糖类抗原(carbohydrate antigen,CA)125、CA19-9对卵巢交界性肿瘤(borderline ovarian tumor,BOT)及上皮性卵巢癌(epithelial ovarian cancer,EOC)的诊断价值。方法以术后组织病理为金标准,180例卵巢上皮性肿瘤患者中60例BOT者为BOT组,120例EOC者为EOC组。比较2组患者血清CA125、CA19-9水平与其临床病理特征。结果 EOC组血清CA125水平(361.75u/mL)高于BOT组(17.61u/mL)(P0.01),EOC组和BOT组血清CA19-9水平(10.20、10.26u/mL)比较差异无统计学意义(P0.05);CA125、CA19-9鉴别BOT、EOC的AUC分别是0.850(95%CI:0.794~0.907,P=0.000)、0.448(95%CI:0.363~0.533,P=0.078),当CA125的cut-off值为51.21u/mL时,其敏感性、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比分别为80%、80%、88.9%、66.7%、4.00、0.25,CA125鉴别BOT、EOC的准确性为80%;浆液性EOC、浆液性肿瘤(包括BOT、EOC)的CA125阳性率(88.2%、73.0%)高于CA19-9(18.6%、17.7%)(P0.05);浆液性肿瘤的CA125阳性率(73.0%)高于黏液性肿瘤(30.8%),黏液性肿瘤的CA19-9阳性率(34.6%)高于浆液性肿瘤(17.7%)(P0.05)。结论当CA12551.21u/mL,对EOC和BOT的鉴别诊断有重要价值,而CA19-9对其鉴别无意义。     

血清CA19-9、CEA、CA125联合检测对胰腺癌同期放化疗患者诊断及预后的临床意义

目的明确检测血清癌抗原19-9(cancer antigen 19-9,CA19-9)、癌胚抗原(carcinoembryonic antigen,CEA)、癌抗原125(cancer antigen 125,CA125)在胰腺癌诊断及治疗过程中的作用及意义。方法采用回顾性分析的方法,对本院24例同步放化疗胰腺癌患者血清CA19-9、CEA及CA125进行相关比较,以明确联合检测对胰腺癌诊断的敏感度、治疗前血清标记物水平与临床分期及预后的关系、治疗前后血清肿瘤标记物变化程度与临床疗效及预后的关系。结果在胰腺癌诊断方面,CA19-9敏感度最高可达87.5%,若联合检测敏感度可达95.8%;治疗前各血清标记物水平与临床分期无关;治疗前CA19-9≥200 kU/L、CEA≥10μg/L、CA125≥50 kU/L者中位生存期明显短于CA19-9<200 kU/L、CEA<10μg/L、CA125<50 kU/L者,分别为8.0(1.4)个月vs 15.0(3.7)个月,6.0(1.8)个月vs12.0(1.7)个月,6.0(1.6)个月vs 12.0(5.6)个月(P<0.05或<0.01);而治疗前后任何异常血清标记物下降≥50%,其总缓解率为43.0%,疾病控制率为100%,中位生存期为12.0(3.2)个月。结论 CA19-9、CEA及CA125联合检测可提高胰腺癌诊断的敏感度,动态观察标记物的变化对判断疗效及预后有一定意义。     

CA19-9、CA242、CEA胰腺肿瘤标记物与胰腺癌可切除性的相关性研究

目的 观察胰腺癌患者血清肿瘤标记物CA19-9、CA242、癌胚抗原（CEA）的表达，试图寻找将影像学认为可切除而实际无法切除的患者筛选出来的敏感指标。方法 采用免疫分析法和放射免疫法检测23例可切除和45例未能切除共68例胰腺癌患者的血清CA19-9、CA242、CEA3种胰腺肿瘤标记物的表达，并进行对照研究。结果 3种肿瘤标记物中CA19-9、CA242浓度不可切除组明显高于可切除组（P=0．01。P=0．02），而CEA2组间无差异（P=0．08）。结论 血清CA19-9、CA242的明显升高可作为判断胰腺癌无法切除的辅助指标。     

围术期癌胚抗原联合术后糖类抗原19-9及糖类抗原125预测Ⅰ～Ⅲ期结直肠癌预后的价值

目的探讨Ⅰ～Ⅲ期结直肠癌(CRC)患者围术期癌胚抗原(CEA)水平变化与临床病理特征、疾病进展的关系,分析术后糖类抗原125(CA125)、糖类抗原19-9(CA19-9)对评估术后CEA阴性患者预后的价值。方法选取2013年1月—2016年12月苏州大学附属第一医院接受根治性手术的结直肠癌患者287例。应用χ2检验、Kaplan-Meier法、Log-rank检验、Cox风险回归模型分析患者围术期CEA、术后CA125联合CA19-9与临床病理特征及预后的关系。结果所有患者中位随访时间为49个月。术后CEA阳性与不良T分期(T_3、T_4)、N分期(N_1、N_2)和TNM分期均显著相关(P 0.01),与癌结节和神经侵犯显著相关(P 0.05)。单因素分析发现,N分期、TNM分期、肿瘤分化程度、癌结节、脉管癌栓、神经侵犯、CA19-9和CA125是影响无病生存期(DFS)的相关因素(P 0.05),N分期、肿瘤分化程度、癌结节、CA19-9和CA724是影响总生存期(OS)的相关因素(P 0.05)。多因素分析显示,术后CA125阳性(P 0.001)和癌结节(P 0.05)是术后CEA阴性患者DFS的独立预后危险因素,癌结节(P 0.05)和肿瘤分化程度(P 0.05)是影响OS的重要因素。术前和术后CEA均阴性组患者的DFS和OS高于术前或术后CEA阳性组,术后CEA降至正常组的DFS、OS高于术后CEA未降至正常组,术后CA19-9和CA125均阴性者DFS、OS高于术后CA19-9或CA125阳性者,差异均有统计学意义(P 0.05或P 0.01)。结论围术期血清CEA水平变化直接影响CRC患者的预后,术前及术后CEA阴性或者术后早期CEA降至正常的患者预后较好。对于术后CEA阴性患者,术后CA125或CA19-9表达阳性提示术后复发、转移风险增高,预后不佳。     

血清CA125联合CA19-9及CEA检测应用于大肠癌诊断的临床价值

目的研究血清CA125联合CA19-9及CEA检测对大肠癌诊断的临床意义。方法我院2009年1月至2011年8月期间收治并手术确诊的大肠癌患者78例为研究对象,选取同期正常体检者100例正常人为对照组,用酶联免疫吸附测定两组血清CA125、CA19-9和CEA水平,并进行比较分析。对各指标均数比较采用组间t检验,计数资料采用组间χ2检验,检验水平P=0.05。结果大肠癌组血清CA125、CA19-9和CEA阳性率分别为33.3%(26/78)、37.2%(29/78)和34.6%(27/78),对照组分别为4%(4/100)、5%(5/100)和7%(7/100),两组患者三种指标阳性率分别比较差异具有统计学意义,P<0.05。大肠癌组Dukes A+B期、Dukes C+D期三种肿瘤指标阳性率相比较差异均有统计学意义,P<0.05。不同组织学类型大肠癌血清CA125、CA19-9阳性率差异无统计学意义,P>0.05;但是不同组织学类型大肠癌CEA阳性率差异具有统计学意义,P<0.05。结论大肠癌血清CA125、CA19-9和CEA检测能够帮助评估肿瘤进展及病情分期,值得临床进一步推广应用。     

胃肠道肿瘤标志物在胰腺癌中的诊断价值

目的探讨血清癌胚抗原(CEA)、癌抗原19-9(CA19-9)、癌抗原125(CA125)、癌抗原724(CA724)、癌抗原50(CA50)对胰腺癌的临床诊断价值。方法用雅培ARCHITECT i2000型化学发光仪检测18例胰腺癌患者、20例胰腺术后患者、15例胰腺炎患者及14例健康体检者血清CEA、CA19-9、CA125、CA724、CA50的含量,胰腺癌组分别与良性病变组和正常对照组比较。结果胰腺癌组中CA19-9、CA125、CEA血清水平较胰腺良性疾病组和健康查体组明显升高,其中以血清CA19-9水平升高最显著。与健康人相比,胰腺良性病组CA19-9、CEA、Ca724升高,差异有统计学意义(P0.05)。而各组CA724未出现统计学差异。CA19-9诊断胰腺癌灵敏度为77.8%,特异度为83.7%,准确率为79.1%。CA19-9+CA125联合检测灵敏度和特异度最高,分别为100%和79.6%,准确率为85.1%。结论血清CA19-9、CEA、CA125在胰腺癌的诊断中有一定的临床应用价值,联合应用可提高胰腺癌的诊断率。     

Prognostic value of preoperative CEA,CA 19-9, CA 72-4, and AFP levels in gastric cancer

INTRODUCTION: Recent research has suggested that serum tumor markers can give valuable prognostic information in gastric cancer. In this study, we examined the relationship between preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 72-4, and alfa fetoprotein (AFP) levels on clinicopathologic significance in gastric cancer patients. METHODS: Preoperative plasma levels of CEA, CA 19-9, CA 72-4, and AFP were retrospectively examined in 95 patients who underwent surgical resection for gastric cancer, and the prognostic value of the tumour markers were estimated. RESULTS: The percentage of CA 19-9, CA 72-4, CEA, and AFP-positive cases were 41%, 32.6%, 24.2%, and 8.4%, respectively. CEA was more frequently positive in the patients with liver metastases (P=0.02). CA 19-9 was more frequently positive in patients with lymph node (P=0.005), peritoneal (P=0.01), and serosal (P=0.03) involvement. CA 72-4 was more frequently positive in patients with lymph node (P=0.01), peritoneal (P=0.03), and liver (P=0.01) involvement. Low 3-year cumulative survival was associated significantly with elevated serum levels of CEA (P=0.001), CA 19-9 (P=0.001), CA 72-4 (P=0.001), and AFP (P=0.01). In multivariate analysis, age, tumor stage, and CA 72-4 were the only independent prognostic factors. Being positive for CA 72-4 was associated with a 3.8-fold higher risk of death (95% confidence intervals: 1.3, 10.9). CONCLUSION: Our results suggest that high preoperative serum levels of CA 72-4 in gastric cancer patients are associated with a higher risk of death due to gastric cancer.     

阻塞性胆道疾病患者血清糖类抗原19-9和胆红素的研究

目的研究阻塞性胆道疾病患者血清糖类抗原19—9（CA19—9）的变化。方法用电化学发光免疫法测定血清CA19-9,日立7600全自动生化分析仪测定血清胆红素,比较胰腺癌、胆管癌、胆总管结石3组之间的差别,以及各疾病组患者血清CA19-9与血清胆红素的相关性。结果阻塞性胆道疾病患者血清CA19-9、胆红素均显著高于健康对照组,且差异有统计学意义（P〈0．05）;胰腺癌组、胆管癌组患者血清CA19-9中住数分别为459、951U／mL,显著高于胆总管结石组（75U／mL）,且差异有统计学意义（P〈0．05）;胰腺癌组、胆管癌组患者之间血清CA19-9差异无统计学意义（P〉0．05）;3组阻塞性胆道疾病中只有胆总管结石组患者血清CA19—9与胆红素有显著性相关（r=0．356,P〈0．05）。结论血清CA19-9水平有助于胰腺癌、胆管癌的诊断。     

The Second Generation CA125 Assays

Optimal management of ovarian cancer patients can only be provided using the CA 125 serum test for treatment monitoring, early prediction of outcome and early detection of recurrence. The newly introduced second generation CA 125 assays, the Centocor CA 125 II IRMA, the Boehringer Mannheim Enzymun CA 125 II and the BYK Liamat CA 125 II are one-step heterologous double-determinant solid phase assays that utilize the M11 as capture antibody and the original OC 125 as tracer. The CA 125 II assays will probably replace the original CA 125 assays within a short period of time. For comparison reasons the Abbott IMx CA 125 assay was also included in this study.

Highly similar CA 125 distribution patterns were obtained with these new CA 125 II assays. Linear regression analysis in ovarian cancer patients showed the following: Centocor CA 125 II = 0.98×CA 125 IRMA+ 10.7 (r = 0.8717, P<0.0001), Sy|x = 89.9; Enzymun CA 125 II = 1.03×CA 125 IRMA + 9.0 (r=0.8988, P<0.0001), Sy|x = 81.8; BYK Liamat CA 125 II = 1.17×CA 125 IRMA + 0.6 (r = 0.8930, P<0.0001), Sy|x = 96.8. Our first technical and clinical evaluation of these three new CA 125 II assays shows their superior analytical performance, in addition to a high qualitative and quantitative correlation with the original CA 125 IRMA.     

血清四种肿瘤标记物联合检测对肺癌的诊断价值

目的 探讨血清癌胚抗原(CEA)、CA125、CA153、CA199联合检测对肺癌的诊断价值.方法 用化学发光免疫分析法测定58例肺癌患者、38例肺良性病变患者及40名健康体检者血清CEA、CA125、CA153、CA199的含量,评价四项肿瘤标记物联合应用对肺癌的诊断价值.结果 肺癌组的血清CEA、CA125、CA153、CA199含量分别为5.6(1.0～619.0)μg/L、124.5(5.3～994.8)U/ml、14.4(3.1～800.0)U/ml、21.8(2.0～1200.0)U/ml,肺良性病变组分别为1.9(0.6～14.4)μg/L、17.7(1.8～303.6)U/m1、6.8(2.4～20.1)U/ml、9.3(2.0～82.6)U/ml,健康对照组分别为1.4(0.6～5.0)μg/L、9.6(4.4～36.5)U/ml、6.6(3.8～19.9)U/ml、6.4(2.0～58.1)U/ml.肺癌组血清CEA、CA125、CA153、CA199含量明显高于肺良性病变组和健康对照组(P均＜0.01);四项指标联合检测的敏感性为94.8%(55/58),明显高于单一检测[CEA:48.3%(28/58)、CA125:75.9%(44/58)、CA153:20.7%(12/58)、CA199∶31.0%(18/58)].结论 联合检测CEA、CA125、CA153、CA199可提高肺癌的阳性检出率.

Abstract：

Objective To evaluate the clinical value of combined detection of serum CEA, CA125,CA153 and CA199 in lung cancer diagnostec. Methods The serum level of CEA,CA125,CA153 and CA199 in 58 patients with lung cancer,38 patients with benign lung diseases and 40 healthy persons were determinated by Chemiluminesent immunoassay. The data were analyzed to evaluate the diagnostic value of the combination use of four markers. Results The serum levels of CEA,CA125,CA153 and CA199 in lung cancer group were 5.6 (1.0-619. 0) μg/L,124. 5 (5.3 - 994. 8) U/ml,14.4(3. 1 - 800. 0) U/ml and 21.8(2.0 - 1200.0) U/ml respectively ;The serum levels of CEA, CA125, CA153 and CA199 in benign lung diseases were 1.9 (0. 6 -14.4) μg/L, 17. 7 ( 1.8 - 303.6 ) U/ml, 6. 8 ( 2. 4 - 20. 1 ) U/ml and 9. 3 ( 2. 0 - 82. 6 ) U/ml respectively. The serum levels of CEA, CA125, CA153 and CA 199 in healthy controls were 1.4 (0. 6 - 5.0 ) μg/L, 9.6 (4. 4 -36. 5 ) U/ml,6. 6 (3.8 - 19. 9) U/ml and 6. 4 (2.0 - 58. 1 ) U/ml respectively. The levels of markers in the lung cancer group were significantly higher than those in patients with benign lung disease and healthy controllers (Ps ＜ 0. 01 ). The sensitivity of combined measurement was 94. 8%, significantly higher than a single measurement ( CEA 48. 3% ,CA125 75.9% ,CA153 20.7% ,CA199 31.0% ,Ps ＜0. 01 ). Conclusion The combined detection of CEA, CA125, CA153 and CA199 can significantly improve detection sensitivity of lung cancer and might provide valuable laboratory proof for early diagnosis of lung cancer.     

Extremely high serum CA19-9 level along with elevated D-dimer in assisting detection of ruptured ovarian endometriosis

BackgroundTo clarify clinical importance of serum CA19-9, CA-125, and plasma D-dimer (D-D) levels in detecting spontaneously ruptured ovarian endometriosis (OE).Materials and MethodsWe retrospectively examined 173 patients with endometriosis out of 735 cases of OE between 2013 and 2019. Among these, 21 cases were diagnosed as “spontaneously ruptured” after surgery, while the remaining cases were unruptured. Venous blood was collected pre-operatively to detect CA19-9, CA-125, and D-D levels. A receiver operating characteristic curve analysis was applied to test clinical value of each marker.ResultsAmong the 21 patients with ruptured OE, 16 had a history of pelvic cysts, 19 claimed sudden onsets of lower abdominal pain, and fluid accumulation were detected in cul-de-sac in only six participants by ultrasound. For serological investigation, both CA19-9 and D-D were significantly elevated in the ruptured OE group (343.09 ± 367.67 U/ml vs. 36.84 ± 40.01 U/ml, 3.39 ± 4.90 mg/L vs. 0.43 ± 0.29 mg/L, both p < .0001). The area under curve (AUC) value for the combination of CA19-9 and D-D was 0.975 (95% CI, 0.939 − 0.993), with specificity of 96.69%, and sensitivity of 85.71%. The combination of CA-125, CA19-9 and D-D showed the highest AUC value that up to 0.976 (95% CI, 0.940–0.993), with sensitivity of 95.24%, and specificity of 87.50%.ConclusionThe combination of CA19-9 and D-D can be chosen as an effective and economical indicators to identify patients with spontaneously ruptured OE in pre-operation assessment. However, from the perspective of differential diagnosis, the combination of CA-125, CA19-9 and D-D is the best choice.

Key messages

• Taking into account the economic effect, the combination of CA19-9 and D-D can be chosen as an effective indicators to identify patients with spontaneously ruptured OE in pre-operation assessment.
• From the perspective of differential diagnosis, the combination of CA-125, CA19-9 and D-D is the best choice to identify patients with spontaneously ruptured OE.

     

血清铁蛋白及CAl9-9、CA242和CEA联合检测对胰腺癌的诊断价值

目的探讨血清铁蛋白（sF）及糖类抗原19-9（CAl9-9）、糖类抗原242（CA242）和癌胚抗原（CEA）在胰腺癌患者中的阳性率的区别。方法选取2009年至2010年住院确诊胰腺癌患者61例,收集他们血清铁蛋白、cAl9-9、CA242和CEA的检测结果,并比较它们在胰腺癌的阳性率。结果胰腺癌患者血清CA242的阳性率最高达76．9％,血清铁蛋白、CAl9-9和CEA的阳性率分别是74．4％、56％和51．3％。将铁蛋白、CA242和CAl9-9联合检测后,阳性率提高至86．5％。结论血清铁蛋白、CA242、CAl9-9和CEA联合检测在胰腺癌诊断中阳性率有较大提高,可以用于胰腺癌诊断。