微小RNA-143、糖类抗原19-9在胰腺癌诊断和预后预测中的应用价值

目的 探讨微小RNA(miRNA)-143、糖类抗原19-9(CA19-9)在胰腺癌诊断和预后预测中的应用价值。方法 选取100例胰腺癌患者、30例胰腺良性病变患者及30例健康体检者,分别作为胰腺癌组、胰腺良性病变组及健康组。比较3组研究对象的血清miRNA-143、CA19-9水平,绘制受试者工作特征（ROC）曲线,分析血清miRNA-143、CA19-9单独及联合检测对胰腺癌的诊断价值,采用Spearman相关分析法分析血清miRNA-143与CA19-9表达的相关性。对胰腺癌患者进行3年随访,分析血清miRNA-143、CA19-9表达与胰腺癌患者预后的关系。结果 胰腺癌组患者的血清miRNA-143水平低于胰腺良性病变组和健康组,CA19-9水平高于胰腺良性病变组和健康组,差异均有统计学意义（P﹤0.05）;胰腺良性病变组和健康组的血清miRNA-143水平比较,差异无统计学意义（P﹥0.05）;胰腺良性病变组患者的血清CA19-9水平高于健康组,差异有统计学意义（P﹤0.05）。血清miRNA-143联合CA19-9检测对胰腺癌的诊断价值最高,其次是血清miRNA-143、血...     

CA19-9、CA50、CA242、CEA检测对胰腺癌早期诊断的意义

目的　探讨CA19- 9、CA5 0、CA2 42、CEA肿瘤标志物联合检测对早期诊断胰腺癌 (PCA)的意义。方法　采用放射免疫分析法 ,检测 5 6例PCA患者及 5 4例胰腺良性疾病患者血清CA19- 9、CA5 0、CA2 42、CEA值并进行比较分析。结果　PCA患者血清CA19- 9(10 8± 148)、CA5 0 (45± 80 )、CA2 42 (78± 5 4)、CEA(3 5± 2 7)。与对照组血清CA19- 9(2 9± 3 6) ,CA5 0 (2 0± 3 0 )、CA2 42 (2 0± 14)、CEA(2 5± 12 )比较有非常显著差别(P <0 0 1)。结果　胰腺恶性肿瘤患者中 ,血清CA19- 9、CA5 0、CA2 42、CEA标志物含量明显高于胰腺良性疾病 ,且CA19- 9阳性率较高 (76 8% )。肿瘤越大CA19- 9水平越高 ;当癌肿手术后复发、转移时 ,均有CA19- 9再度明显升高 ,可早期发现以随时调整治疗方案。PCA标志物联合检测阳性率 (92 % ) ,明显高于单检阳性率 (76 8% )。四种标志物之间有相关性及互补性 ,可显著提高PCA的早期诊断 ,并有助于与良性胰腺疾病鉴别     

胰腺癌患者血清MCP-1的检测及其临床意义

目的:探讨胰腺癌患者血清中单核细胞趋化蛋白-1(MCP-1)的水平及其临床意义。方法:用ELISA方法检测胰腺癌患者42例,胰腺良性病变32例,健康体检者30例血清中MCP-1水平。结果:胰腺癌患者血清MCP-1的水平明显高于健康对照组(212.3±26.2 vs 90.2±12.9)(P<0.01),差别具有统计学意义;胰腺癌组与胰腺良性病变组相比,其MCP-1的水平也升高(212.3±26.2 vs 114.5±17.3)(P<0.01),差别具有统计学意义。在胰腺癌组中,有远处转移的血清MCP-1水平明显高于无远处转移的(260.1±32.4vs 180.5±42.4)(P<0.01);有淋巴转移的血清MCP-1水平明显高于无淋巴转移的(260.4±32.5 vs 123.2±18.3)(P<0.01)。结论:检测血清中MCP-1的水平对于胰腺癌及良性胰腺病变的鉴别诊断,以及判断胰腺癌是否有远处转移及淋巴转移可能具有重要的意义。     

甲胎蛋白、癌胚抗原和糖链抗原19-9联合检测诊断消化系统恶性肿瘤的价值分析

目的 探讨甲胎蛋白(AFP)、癌胚抗原(CEA)和糖链抗原19-9(CA19-9)联合检测对消化系统恶性肿瘤的诊断价值.方法 回顾性分析300例消化系统恶性肿瘤患者和108例消化系统良性病变患者的临床资料,记录患者的血清AFP、CEA和CA19-9水平,评价其诊断效能.结果 肝癌患者的血清AFP、CEA和CA19-9水平均高于肝硬化患者,胃癌、胰腺癌和结直肠癌患者的血清CEA和CA19-9水平分别高于胃溃疡、胰腺炎和溃疡性结肠炎患者,差异均有统计学意义(P<0.05).单项检测中,AFP对肝癌的诊断敏感度(78.5%)高于CEA和CA19-9(P<0.05);CA19-9对胰腺癌的诊断敏感度(78.2%)高于AFP和CEA(P<0.05).对于肝癌、胃癌、胰腺癌和结直肠癌,3项联合检测的敏感度均高于单项检测(P<0.05).结论 血清AFP、CEA和CA19-9联合检测对消化系统恶性肿瘤的早期诊断具有重要意义,可提高诊断的敏感度,且不会降低特异度.     

血清细胞间黏附分子-1 在胰腺癌诊断和预后评估中的价值

[摘要] 目的：探讨血清细胞间黏附分子-1（intercellular adhesion molecule-1,ICAM-1）在胰腺癌诊断和预后评估中的价值。方法：选取2015 年4 月至2017 年12 月在湖北省肿瘤医院肝胆胰外科就诊的胰腺癌患者80 例（胰腺癌组）、胰腺良性疾病患者40例（良性疾病组）及同期健康体检者30 例（对照组）。分别检测3 组人群血清ICAM-1 和CA19-9 水平;采用受试者工作特征曲线（ROC）分析ICAM-1 对胰腺癌的诊断特性,采用COX回归模型分析血清ICAM-1 与胰腺癌患者预后是否独立相关。结果：胰腺癌组ICAM-1 和CA19-9 水平明显高于良性疾病组和对照组（均P<0.01）,良性疾病组CA19-9 水平明显高于对照组（P<0.01）。血清ICAM-1、CA19-9 以及两者联合的曲线下面积（AUC）为0.732（95%CI：0.658~0.807,P=0.000）、0.691（95%CI:0.620~0.762, P=0.000）、0.747（95%CI ：0.674~0.821,P=0.000）;ICAM-1与CA19-9之间呈显著正相关（r=0.472,P=0.000）。血清ICAM-1<2 308 U/ml患者的生存时间明显长于≥2 308 U/ml 的患者（χ2=28.357,P=0.000）;ICAM-17≥2 308 U/ml 是患者预后的独立影响因子,其OR为3.08（2.14~7.23）。结论：血清ICAM-1 有助于胰腺癌的早期诊断和预后评估。     

糖抗原CA19-9和CA50在良恶性胰腺和胆道疾病中的价值

近年来,临床上已应用单克隆抗体技术诊断胃肠道疾病。作者对129例(包括胰腺癌26例、胆管癌23例、良性胰腺疾病26例和54例例良性胆道疾病)患者测定血清CA19一9和CA5。水平,以了解此二种肿瘤标志物对胰腺和胆道疾病患     

联合检测血清肿瘤标志物对胰腺癌的诊断价值

目的探讨血清肿瘤标志物联合检测对胰腺癌的诊断价值。方法选取2016年7月至2019年4月间山东省职业卫生与职业病防治研究院收治的52例胰腺癌患者为胰腺癌组,58例胰腺良性患者为良性组,60例同期体检健康者为健康对照组。比较三组受试者血清糖链抗原19-9(CA19-9)、糖链抗原242(CA242)、胸苷激酶1(TK1)、肿瘤特异生长因子(TSGF)及不同临床分期的水平;评估CA19-9、CA242、TK1及TSGF联合检测对胰腺癌患者的临床诊断价值。结果三组受试者血清CA19-9、CA242、TK1及TSGF水平比较差异显著,且胰腺癌组上述指标高于其他两组,良性组上述指标高于健康对照组,差异均有统计学意义(均P <0. 05)。四期胰腺癌患者CA19-9、CA242、TK1及TSGF水平比较差异显著,且随着期数上升,CA19-9和CA242逐渐升高,Ⅲ～Ⅳ期胰腺癌患者TK1及TSGF均高于Ⅰ～Ⅱ期,差异均有统计学意义(均P <0. 05)。将CA19-9、CA242、TK1及TSGF四项纳入Logistic回归模型,四项联合敏感度和特异度为88. 5%和94. 8%,均高于单项检测。结论血清CA19-9、CA242、TK1及TSGF水平与胰腺癌关系显著,且联合检测敏感度和特异度较高,对胰腺癌的诊断和治疗具有重要价值。     

LRG1及CA19-9在胰腺癌患者血清中的表达及临床意义

目的:研究富含亮氨酸的α-2糖蛋白 1(leucine rich alpha-2 glycoprotein 1,LRG1)在胰腺癌患者血清中的表达,探讨联合检测LRG1、CA19-9对胰腺癌的诊断价值。方法:共纳入50例胰腺癌患者、30例慢性胰腺炎患者、50例健康志愿者;分别采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA法)检测三组血清中LRG1和CA19-9水平,分析其与肿瘤临床分期的关系,比较单独检测LRG1和CA19-9与两者联合检测诊断胰腺癌的敏感性和特异性。结果:与慢性胰腺炎组及健康查体组相比,胰腺癌组血清中LRG1和CA19-9水平明显偏高(P<0.01),慢性胰腺炎组和正常对照组比较差异无统计学意义(P>0.05);胰腺癌临床分期与患者血清LRG1水平相关,Ⅲ、Ⅳ期恶性肿瘤患者血清LRG1水平明显高于I、Ⅱ期恶性肿瘤患者,差异有统计学意义(P<0.05);联合检测LRG1、CA19-9 受试者工作特征曲线下面积大于单独检测CA19-9(P<0.05)。结论:LRG1可作为胰腺癌诊断潜在的生物标志物,联合检测血清LRG1及CA19-9水平可提高胰腺癌的早期诊断率。     

血清CA19—9对胰腺癌诊断的临床评价

通过对40例胰腺癌与92例消化道恶性肿瘤，115例消化道良性疾患的血清CA19－9的检测，并结合B超、CT检查，评价血清CA19－9对胰腺癌的诊断和临床应用价值。结果，胰腺癌患者的血清CA19－9阳性率为90．0％，均值为196．7±98．8u／Vml，均明星离于肝癌，胃十二指肠癌，结直肠癌，胰腺良性疾患，胆石症和良性梗阻性黄胆（P＜0.01）；若联合B超、CT、PTC、ERCP检查，胰腺癌的诊断符合率可达100％，并可排除胆系恶性肿瘤。血清CA19－9与胰腺癌的临床分期，肿瘤大小，部位无明显关系。但可作为预后的判断和病情追踪的指标，有助于胰腺癌手术疗效评价与术后随访监测。     

宫颈癌患者血浆溶血磷脂酸表达临床意义的探讨

目的:探讨血浆溶血磷脂酸(LPA)在宫颈癌中的表达及临床意义。方法:利用化学比色法检测135例宫颈癌和85例宫颈良性疾病患者及40位健康体检者(对照组)血浆溶血磷脂酸含量,同时采用电化学发光法检测血浆CYFRA21-1含量并作对比分析。结果:宫颈癌组患者血浆LPA水平为(5.11±1.92)μmol/L,明显高于对照组的(2.31±0.45)μmol/L,P<0.01;宫颈良性疾病组患者血浆LPA水平为(2.46±1.05)μmol/L,与对照组比较差异无统计学意义,P>0.05。血浆LPA对宫颈癌诊断的灵敏度和特异度分别为67.4%和97.5%,CYFRA21-1的灵敏度和特异度分别为41.5%和95.0%,LPA均优于CYFRA21-1。血浆LPA和CYFRA21-1在宫颈鳞状上皮癌的表达分别为71.0%和43.5%,均高于腺癌+腺角化癌的27.3%和18.2%,P值均<0.05。宫颈癌晚期(Ⅲ+Ⅳ期)CYFRA21-1阳性率53.2%,明显高于早期(Ⅰ+Ⅱ期)的14.6%;有远处转移的宫颈癌患者血浆LPA阳性率91.9%,明显高于无远处转移者的24.5%,P<0.05。结论:LPA可能与宫颈癌的浸润和转移有关;血浆LPA检测对宫颈癌的诊断及鉴别诊断具有一定的临床应用价值。     

溶血磷脂酸及其受体在卵巢上皮癌中的表达及其临床意义

目的：探讨溶血磷脂酸（lysophosphatidic acid,LPA）及其3种受体亚型（LPA1、LPA2、LPA3）在卵巢上皮癌发生和发展中的作用及可能机制。方法：采用RT—PCR技术检测24例卵巢上皮癌和18例卵巢良性上皮肿瘤组织中LPA1、LPA2、LPA3的表达;用生化测定法检测24例卵巢上皮癌和18例卵巢良性上皮肿瘤患者和10例健康妇女的血浆LPA水平。结果：LPA2与LPA3在卵巢上皮癌组织中的表达水平明显高于卵巢良性上皮肿瘤组织（P值均〈0．001）,而LPA1在这两者间的表达水平无显著差异。卵巢上皮癌患者血浆LPA水平明显高于卵巢良性上皮肿瘤患者及健康妇女（P值均〈0．001）,后两者间血浆LPA水平无显著性差异;Ⅲ-Ⅳ期患者的血浆LPA水平高于Ⅰ-Ⅱ期患者,但无显著性差异。结论：LPA及其受体LPA2、LPA3可能在卵巢上皮癌的发生和发展中起重要作用。     

卵巢上皮癌患者血浆LPA水平检测的临床意义

目的探讨溶血磷脂酸(lysophosphatidic acid,LPA)在卵巢上皮癌发生和发展中的作用及临床意义。方法用生物化学法检测24例卵巢上皮癌、18例卵巢良性上皮肿瘤患者和10例健康妇女的血浆LPA水平。结果卵巢上皮癌患者血浆LPA水平明显高于卵巢良性上皮肿瘤患者及健康妇女(P<0.001),后两者血浆LPA水平差异无统计学意义;卵巢上皮癌患者血浆LPA的水平Ⅲ~Ⅳ期高于Ⅰ~Ⅱ期,但是差异无统计学意义(P>0.05)。结论LPA在卵巢上皮癌患者中呈高表达,具有潜在的早期诊断价值。     

CEA, CA 19-9, and CA 125 in the differential diagnosis of benign and malignant pancreatic diseases with or without jaundice

BACKGROUND AND OBJECTIVES: In this study, the value of the serum tumor markers carcinoembryonic antigen (CEA), CA 19-9, and CA 125 was assessed in the differential diagnosis of benign and malignant pancreatic diseases with and without obstructive jaundice. METHODS: Serum levels of CEA, CA 19-9, and CA 125 were measured by immunoradiometric assay before the treatment in 123 patients with pancreatic carcinoma and 58 patients with a benign pancreatic disease. RESULTS: The sensitivity of CEA, CA 19-9, and CA 125 in the diagnosis of pancreatic carcinoma was 39.0%, 81.3%, and 56.9%; and specificity was 91.4%, 75.9%, and 77.6%, respectively. Although there was no significant difference between the CA 19-9 positivity ratios of the jaundiced (84.3%) and nonjaundiced (73.5%) patient subgroups of the pancreatic carcinoma, this ratio was significantly higher in the jaundiced subgroup (64.7%) than the nonjaundiced subgroup (7.3%) of the benign pancreatic diseases (P < 0.001). The CEA and CA 125 positivity ratios of jaundiced and nonjaundiced subgroups of patients with benign and malignant pancreatic diseases were not significantly different. CONCLUSIONS: In the differential diagnosis of pancreatic carcinoma from benign pancreatic diseases, CA 19-9 can be useful in the nonjaundiced patients, whereas CA 125 provides a limited contribution in jaundiced patients.     

The diagnostic value of the foetoacinar pancreatic (FAP) protein in cancer of the pancreas; a comparative study with CA19/9

The serum diagnostic value of the foeto-acinar pancreatic protein (FAP protein), an oncofoetal pancreatic antigen, was tested in 201 patients. Of these, 112 suffered from malignant disease (57 patients had pancreatic carcinoma and 55, extra-pancreatic malignancies) and 89 had benign disease (49 patients with hepato-pancreato-biliary disease and 40 with other benign disease). FAP protein was measured by a competitive radioimmunoassay. In this technique, the normal cut-off level was 10% inhibition. This was deducted from values in 32 normal sera. FAP protein levels superior to 10% inhibition were found in 86% of patients with pancreatic cancer, in 31% with non-pancreatic malignancy, in 69% with benign hepato-pancreato-biliary disease and in 20% with other benign diseases. Accordingly, sensitivity of FAP protein for pancreatic carcinoma was 86% and specificity, 66%. However, high FAP protein levels (greater than 30% inhibition) were almost exclusively seen in patients with pancreatic cancer. At this cut-off level, specificity increased to 95% but sensitivity decreased to 51%. Determination of the carbohydrate antigen CA19/9 was made in parallel by a commercially available assay. At the cut-off level of 37 u ml-1, CA19/9 in our serum panel had a sensitivity of 74% for pancreatic carcinoma and a specificity of 88%. In pancreatic cancer 55 out of 57 patients had elevated levels of either FAP protein or CA19/9 (sensitivity; 96%).     

Loss of Lewis antigen expression on erythrocytes in some cancer patients with high serum CA19-9 levels

The Lewis (Le) phenotype of both erythrocytes and sera and serum CA19-9 levels were studied in 49 patients with pancreatic carcinoma, in 37 with gastric cancer, in 22 with colorectal cancer, in 21 with bile duct carcinoma, and in 19 with hepatocellular carcinoma. The Le phenotype was determined in sera with the use of the dot-immunobinding assay and on erythrocytes. The localizations of the Le antigen and CA19-9 were studied in pancreatic tissues from 22 patients with pancreatic carcinoma. The prevalence of Le(a-,b-) on erythrocytes was significantly higher in patients with pancreatic carcinoma than in normal controls. Nineteen of 21 patients with pancreatic carcinoma, whose Le phenotype on erythrocytes was Le(a-,b-), had Le antigen in tissues and sera, and they had a raised serum CA19-9 level. The remaining 2 patients were of the Le(a-,b-) phenotype for both erythrocytes and sera, and their serum CA19-9 levels were below 6 U/ml. Neither Le antigen nor CA19-9 could be localized in tissues of these 2 patients. Two patients with gastric cancer, 6 with colorectal cancer, and 6 with bile duct carcinoma had Le antigen in sera in spite of having Le(a-,b-) on erythrocytes. These results indicate that the Le phenotype on erythrocytes can undergo a change not infrequently in patients with pancreatic carcinoma as well as in patients with other gastrointestinal cancers, but patients with the Le(a-,b-) phenotype in sera cannot synthesize CA19-19.     

Serological test of carbohydrate antigen CA50 in patients with cancer of the digestive tract

In order to determine the clinical usefulness of carbohydrate antigen CA50 as a marker for cancers of the digestive tract, an attempt was carried out to measure the CA50 levels (normal level less than or equal to 18.1 U/ml) in sera of patients with various diseases of the digestive tract including pancreatic cancer. In patients with pancreatic cancer, the frequency of elevation of CA50 was 85.7% (6/35), which was the highest frequency of elevation, and a serum level of over 1,000 U/ml was observed in 6 (17.1%) of these 35 pancreatic cancer patients. Furthermore, patients with gall bladder carcinoma, hepatocellular carcinoma and gallstones showed relatively high frequencies of elevation. On the other hand, the maximum level of CA50 in serum was 41 U/ml in patients with benign pancreatic disease. Therefore, it was thought that CA50 was able to differentiate pancreatic cancer from benign pancreatic disease in patients with pancreatic disease with extremely high levels of CA50. The serum level of CA50 showed significant correlation with that of CA19-9. This study suggested that CA50 might be a potentially useful marker.     

Overexpression of Tbx3 Predicts Poor Prognosis of Patients with Resectable Pancreatic Carcinoma

Background: To determine the expressions of Tbx3, a member of subgroup belonging to T-box family, andits prognostic value in pancreatic carcinoma. Materials and Methods: We determined the expression levels ofTbx3 on both mRNA and protein levels in 30 pairs of fresh tumor tissues and paratumor tissues by quantitativereal-time polymerase chain reaction (qRT-PCR) and Western blotting, respectively. In addition, protein levelof Tbx3 were identified using immunochemistry in 80 pairs of paraffin-embedded specimen. The correlationsbetween Tbx3 expression and various clinicopathological parameters as well as overall survival were evaluated.Results: Tbx3 mRNA and protein levels in tumor tissues were significantly higher than in the paratumor tissuesby qRT-PCR (0.05 ±0.007 vs. 0.087±0.001, p<0.001) and western blotting (1.134±0.043 vs. 0.287±0.017, p<0.001).The statistical analysis based on immunohistochemical evaluation suggested that Tbx3 aberrant expressionwas significantly associated with several conventional clinicopathological variables, such as gender, age, tumorposition, preoperative CA19-9 level, pathological T staging and N staging. Univariate and multivariate analysesrevealed that Tbx3 expression was an independent prognostic factor for overall survival (<0.001). Conclusions:Our results suggest that overexpression of Tbx3 is associated with poor prognosis of pancreatic cancer patients.However, additional clinical trials are needed to accurately validate this observation.     

Applicative Value of Serum CA19-9, CEA,CA125 and CA242 in Diagnosis and Prognosis for Patients with Pancreatic Cancer Treated by Concurrent Chemoradiotherapy

Objective: To evaluate the application value of serum CA19-9, CEA, CA125 and CA242 in diagnosis andprognosis of pancreatic cancer cases treated with concurrent chemotherapy. Materials and Methods: 52patients with pancreatic cancer, 40 with benign pancreatic diseases and 40 healthy people were selected. Theelectrochemiluminescence immunoassay method was used for detecting levels of CA19-9, CEA and CA125, anda CanAg CA242 enzyme linked immunoassay kit for assessing the level of CA242. The Kaplan-Meier methodwas used for analyzing the prognostic factors of patients with pancreatic cancer. The Cox proportional hazardmodel was applied for analyzing the hazard ratio (HR) and 95% confidential interval (CI) for survival timeof patients with pancreatic cancer. Results: The levels of serum CA19-9, CEA, CA125 and CA242 in patientswith pancreatic cancer were significantly higher than those in patients with benign pancreatic diseases andhealthy people (P<0.001). The sensitivity of CA19-9 was the highest among these, followed by CA242, CA125and CEA. The specificity of CA242 is the highest, followed by CA125, CEA and CA19-9. The sensitivity andspecificity of joint detection of serum CA19-9, CEA, CA125and CA242 were 90.4% and 93.8%, obviouslyhigher than single detection of those markers in diagnosis of pancreatic cancer. The median survival time of52 patients with pancreatic cancer was 10 months (95% CI7.389~12.611).. Patients with the increasing level ofserum CA19-9, CEA, CA125, CA242 had shorter survival times (P=0.047. 0.043, 0.0041, 0.029). COX regressionanalysis showed that CA19-9 was an independent prognostic factor for patients with pancreatic cancer (P=0.001,95%CI 2.591~38.243). Conclusions: The detection of serum tumor markers (CA19.9, CEA, CA125 and CA242)is conducive to the early diagnosis of pancreatic cancer and joint detection of tumor markers helps improve thediagnostic efficiency. Moreover, CA19-9 is an independent prognostic factor for patients with pancreatic cancer.     

Tissue polypeptide specific antigen (TPS), a marker for differentiation between pancreatic carcinoma and chronic pancreatitis. A comparative study with CA 19-9

BACKGROUND: The value of serum tissue polypeptide specific antigen (TPS) as a complement to CA 19-9 in the detection of pancreatic carcinoma was determined prospectively. TPS and CA 19-9 levels obtained at the time of diagnosis in patients suspected of having chronic pancreatitis or pancreatic carcinoma were evaluated in receiver operating characteristic (ROC) curve analysis. METHODS: Serum TPS and CA 19-9 levels were measured by immunoassays in 122 subjects, 48 with pancreatic carcinoma and 74 with chronic pancreatitis. RESULTS: Elevated levels of CA 19-9 were detected preoperatively in 70% of pancreatic carcinoma patients and in 19% of chronic pancreatitis patients. Elevated levels of TPS were detected in 100% of patients with pancreatic carcinoma and in 22% of patients with chronic pancreatitis. The median levels of TPS and CA 19-9 for pancreatic carcinoma were significantly higher than those for chronic pancreatitis (P < 0.0001). Increasing the upper reference value of TPS allowed for better discrimination between chronic pancreatitis and pancreatic carcinoma. ROC curve analysis showed that the introduction of 200 U/L as a decision criterion for TPS did not reduce its sensitivity but significantly improved its specificity. At a specificity of 98% for TPS, discrimination between pancreatic carcinoma and chronic pancreatitis was found to be 97%. Increasing the upper reference level for CA 19-9 to attain a specificity of 98% decreased its sensitivity from 70% to 33%. CONCLUSIONS: At an elevated cut-off level for TPS (200 U/L), almost complete discrimination between pancreatic carcinoma and chronic pancreatitis was obtained. TPS will be more useful than CA 19-9 in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis.     

结肠癌患者血清miR-24-3p、CEA和CA199水平及其诊断价值

目的:探讨结肠癌患者血清miR-24-3p、癌胚抗原（carcinoembryonic antigen,CEA）和糖链抗原199（carbohydrate antigen 199,CA199）水平及其诊断价值。方法:选取我院2015年1月至2019年3月收治的168例结肠癌患者（结肠癌组）、120例结肠良性疾病患者（良性病变组）作为研究对象,另招募65例体检正常者作为对照组。检测各组miR-24-3p、CEA及CA199水平。应用受试者工作特征（receiver operating characteristic,ROC）曲线分析血清miR-24-3p、CEA及CA199水平对结肠癌的诊断价值。结果:结肠癌组miR-24-3p水平（5.36±1.27 vs 1.70±0.41、1.25±0.28）、CEA水平［（37.50±10.74）ng/mL vs （2.25±0.62）ng/mL、（1.84±0.35）ng/mL）］及CA199水平［（61.26±18.35）U/mL vs （16.48±11.30）U/mL、（13.70±7.52）U/mL）］较良性病变组和对照组明显升高（P<0.01）。结肠癌患者血清miR-24-3p表达水平与TNM 分期、淋巴结转移、脉管浸润、CEA及CA199阳性有关（P<0.05）。ROC曲线显示,血清miR-24-3p诊断结肠癌的曲线下面积最大（0.826,95%CI:0.765～0.887）,其敏感度为83.6%,特异度为78.0%。结论:血清miR-24-3p表达水平在结肠癌患者中明显升高,且与患者进展相关,与CEA及CA199传统肿瘤标志物相比,miR-24-3p诊断结肠癌的敏感度和特异度均较高,未来可能是鉴别结肠癌和结肠良性疾病的早期筛查指标。