通过ROC曲线评估CA19-9对胰腺癌侵犯血管的诊断价值

目的探讨胰腺癌时CA19-9升高与血管侵犯的关系,应用受试者工作特征(ROC)曲线为CA19-9的临床应用提供更有力的理论支持。方法将经病理证实的我院222例胰腺癌患者分为血管侵犯组和未侵犯组。首先以常规统计学方法比较两组间的CA19-9水平是否具有差异,其次通过ROC曲线进一步评估CA19-9的应用价值,最后比较CA19-9与CA125及CA242的临床价值。结果(1)在血管侵犯发生者中,CA19-9平均为294.6±37.9u/ml,而无血管侵犯者CA19-9平均水平为185.6±23.9u/ml,两者具有显著差异(P=0.016)。(2)CA19-9诊断胰腺癌血管侵犯的ROC曲线下面积为0.641。当CA19-9大于500u/ml时,其判断血管侵犯的特异性高达95%。(3)CA125与CA242的ROC曲线下面积分别为0.562和0.618。结论CA19-9的水平与肿瘤是否发生血性转移有一定关系,CA19-9在常用血清标志物中较CA125与CA242中诊断价值更高。通过ROC曲线可确知当CA19-9大于500u/ml时,判断肿瘤转移的特异性高达95%以上,这为CA19-9的应用提供了一定的临床支持,同时显示ROC曲线在诊断试验中较常用的方法敏感性和特异性更为优越,能够提供更多的信息。     

血清CA19-9水平术前评估胰腺癌可切除性的临床价值

目的 评价血清CA19-9水平在胰腺癌术前可切除性评估中的临床价值.方法 测定52例术前影像学提示有手术切除可能性并经手术活检或术后病理确诊的胰腺癌患者术前血清CA19-9水平,以手术能否切除为金标准,绘制CA19-9的受试者工作特征(ROC)曲线,并以敏感度和特异度之和最大点即曲线左上方作为相应截断点测CA19-9的敏感度、特异度及阳性、阴性预测值.结果 52例胰腺癌患者中手术切除29例(55.8%),未切除23例(44.2%).手术切除组患者血清CA19-9水平为(159.6±170.9)U/ml,未切除组患者为(944.4±773.4)U/ml;CA19-9的ROC曲线下面积0.918(＞0.9),P＜0.01,95%可信区间0.843～0.992,左上方截断点CA19-9值为353.2 U/ml.以此为标准,敏感度93.1%,特异度78.3%,阳、阴性预测值分别为84.4%和90.0%.结论术前血清CA 19-9水平可作为影像学提示有手术切除可能的胰腺癌患者进一步评估的辅助指标.     

胰液端粒酶和K-ras基因检测对胰腺癌的诊断价值

目的探讨胰液端粒酶活性与K-ras基因突变联合检测对胰腺癌患者诊断价值。方法收集25例胰腺癌和21例慢性胰腺炎患者胰液,K-ras基因突变采用聚合酶链反应-限制性酶切片段长度多态性(PCR-RFLP)检测,端粒酶活性检测采用端粒末端重复序列扩增技术(TRAP)。结果胰腺癌中K-ras基因突变率为88.0%(22/25),慢性胰腺炎中K-ras基因突变率仅为19.0%(4/21),P<0.01;在25例胰腺癌中端粒酶阳性检出率为84.0%(21/25);而21例慢性胰腺炎胰液中端粒酶阳性检出率为28.6%(6/21),P<0.01。K-ras基因突变或端粒酶活性阳性检测诊断胰腺癌的特异、敏感性分别为92%,66.7%;两者联合检测诊断胰腺癌的敏感性为80.0%,特异性达到85.7%。结论联合检测胰液中K-ras基因、端粒酶活性可提高胰腺癌诊断的敏感性和特异性,对胰腺癌筛查、诊断和鉴别诊断有一定临床意义。     

胰腺癌患者血清CEMIP、CA19-9和CA242水平变化及其临床意义*

目的 研究胰腺癌患者血清CEMIP、CA19-9和CA242水平变化及其临床意义。方法 2013年4月～2016年8月我院诊治的92例胰腺癌患者、105例胰腺良性疾病患者和选择的83例健康人，采用ELISA法检测血清细胞迁移诱导透明质酸结合蛋白（CEMIP）水平，采用放射免疫法检测血清CA19-9和CA242水平。应用受试者工作特征曲线（ROC）下面积（AUC）评价各指标的诊断效能。采用Kaplan-Meier和Cox风险比例模型行生存分析。采用Logistic回归分析影响术后生存的因素。结果 胰腺癌患者血清CEMIP、CA19-9和CA242水平分别为0.7（0.4，1.0） ng/mL、180.1（89.1，230.3） U/mL和61.7（20.7，93.5）U/mL，均显著高于胰腺良性疾病患者和健康人，差异有统计学意义（P均<0.05）；应用血清CEMIP、CA19-9和CA242联合诊断胰腺癌的AUC为0.966，其诊断效能显著高于任一指标单独诊断；应用血清CEMIP、CA19-9和CA242水平预测胰腺癌患者根治术后1年生存的效能均较高；经Kaplan-Meier和Cox多因素分析，结果表明肿瘤分化程度、血管侵犯、术后化疗、血清CEMIP≥0.7 ng/mL、CA19-9≥90.3 U/mL和CA242≥32.8 U/mL均是影响胰腺癌患者根治术后生存的独立危险因素。结论 检测胰腺癌患者血清CEMIP、CA19-9和CA242水平可有助于对疾病的诊断和预后评估。     

粪便中p53与APC突变检测在大肠癌诊断中的意义

目的探讨在大肠癌患者粪便中检测p53、APC基因突变的可行性及其应用前景和意义。方法从36例大肠癌患者、10例大肠腺瘤患者以及30例正常对照者的粪便中分别提取DNA,应用PCR-SSCP法检测粪便中p53、APC基因突变情况。结果36例大肠癌患者粪便中p53及/或APC基因突变检出率为77.78%(19/36),二者突变率分别为52.78%(19/36)和36.11%(13/36);10例大肠腺瘤中p53基因突变检出率为0%,APC为20%;30例正常对照粪便中p53、APC基因突变检出率均为0%。p53的突变随大肠癌分化程度的降低而增高(P<0.05);APC基因突变与大肠癌组织学类型无关(P>0.05)。结论联合检测粪便中p53与APC突变在大肠癌诊断和筛查中有潜在的应用价值。     

CT和血清CA19-9联合检测在胰腺癌诊断中的价值

目的探讨CT和血清CA19-9联合检测对胰腺癌诊断的价值。方法回顾性分析胰腺病变93例,所有患者术前均行螺旋CT增强扫描及血清CA19-9检测,并对CT、CA19-9以及二者联合检测与病理诊断进行比较。结果 93例胰腺病变患者中,被病理证实为胰腺癌患者63例。经CT诊断为胰腺癌的68例患者中,55例被病理证实为胰腺癌。CT对胰腺癌诊断的敏感性、特异性和符合率分别为87.3%、56.7%和77.4%。胰腺癌患者的血清CA19-9中位值显著高于非胰腺癌患者(426.7 vs 23.7,P<0.001)。60例CA19-9≥37 U/ml的患者中,48例被病理证实为胰腺癌。CA19-9对胰腺癌诊断的敏感性、特异性和符合率分别为76.2%、60.0%和71.0%。CT联合CA19-9检测对胰腺癌诊断的敏感性、特异性和符合率分别为68.3%、90.0%和75.3%。CT、CA19-9以及二者联合检测与病理诊断均有较好的一致性(均P<0.001),但联合检测的一致性更高。以ROC曲线和Youden指数指示的CA19-9判定胰腺癌的最佳阈值(235.1 U/ml)作为诊断分界点时,CA19-9对胰腺癌诊断的敏感性、特异性和符合率分别为65.1%、90%和73.1%,显著提高了诊断的特异性。以235.1 U/ml为诊断分界点,CA19-9与CT联合检测对胰腺癌诊断的敏感性、特异性和符合率分别为60.3%、96.7%和72.1%,进一步提高了诊断的特异性。结论对于无法获取病理组织的患者,CT联合CA19-9检测是临床诊断胰腺癌较好的方法之一。     

胰腺癌患者血浆k-ras基因与肿瘤标志物联合检测及其意义

目的 :了解胰腺癌患者血浆中肿瘤标志物水平和k ras基因突变情况 ,评价基因突变与肿瘤标志物联合检测对胰腺癌患者的诊断价值。方法 :收集经手术或病理确诊为胰腺恶性疾病患者 2 1例 ,ELISA检测血浆CA19 9、CA2 42、CA5 0、CEA水平 ,PCR RFLP检测k ras基因突变 ,并与 11例胰腺良性疾病患者对照。结果 :胰腺癌患者血浆中k ras基因突变率 73.7%,胰腺良性疾病k ras基因无突变。k ras基因突变检测的敏感性与特异性分别为 6 1.9%和10 0 %,血浆k ras、CA19 9、CA2 42联合检测的敏感性和特异性分别为 85 .7%和 71.9%。结论 :联合检测血浆中k ras基因与肿瘤标志物可提高胰腺癌诊断的敏感性 ,对胰腺癌筛查、诊断与鉴别诊断有一定的临床意义。     

肿瘤标志物检测在胰腺癌诊断和预后评估中的价值研究

目的评价胰腺癌肿瘤标志物对胰腺癌诊断及预后的影响。方法收集2007年1月至2011年12月沈阳军区总医院胰腺癌住院患者198例,良性胰腺病50例,正常对照组61名。采用放射免疫分析法检测血清肿瘤标志物CA19-9、CA242、CA50、CA125、CEA。分析回访到生存期的120例胰腺癌患者预后影响因素。结果胰腺癌患者肿瘤标志物CA19-9、CA242、CA125明显增高,与正常对照组及良性胰腺病变组比较差异有统计学意义(P0.05);CA19-9、CA242、CA125、CA50和CEA灵敏度分别为80.84%、72.50%、56.67%、56.12%、45.31%,特异度分别为76.80%、69.32%、72.96%、65.33%、57.40%。联合检测灵敏度有提高,但特异度降低。胰腺癌患者中位生存期5.5个月,胰体尾癌及全胰腺癌较胰头癌生存期短,CA19-9、CA242、CA125升高的患者生存期短(P0.05)。多因素Cox比例风险回归分析显示,CA19-9、CA242是独立预后因素(P0.05)。结论胰腺癌血清肿瘤标志物检测有助于胰腺癌的早期诊断。联合检测肿瘤标志物有助于提高对胰腺癌的诊断效率,胰腺体尾部肿瘤、CA19-9、CA242、CA125升高的患者生存期短。CA19-9、CA242是胰腺癌的独立预后因素,有助于评估预后。     

血清肿瘤标志物和肝功能指标联合检测在胰腺癌肝转移诊断中的价值

目的探讨肿瘤标志物和肝功能指标联合检测在胰腺癌肝转移早期诊断中的临床价值。方法选取125例胰腺癌患者,其中肝转移58例,无肝转移67例。检测患者血清肿瘤标志物和肝功能指标水平,并对结果进行分析。结果胰腺癌肝转移者血清中癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、糖类抗原242（CA242）和乳酸脱氢酶（LDH）水平显著高于无肝转移者（P〈0.05）。ROC曲线分析显示CEA、CA19-9、CA242与LDH诊断肝转移的最佳上限为6.0μg/L、842 U/m l、64.48 U/L与220 U/L。CEA和LDH单独检测肝转移的敏感性为64.2%和51.9%,特异性为71.4%和74.2%。而CEA与LDH联合检测的敏感性和特异性为77.6%和93.5%。结论肿瘤标志物和肝功能指标联合检测特异性高,有助于胰腺癌肝转移的早期诊断。     

胰液K-ras基因突变和血清CA19-9联合检测判断胰腺癌复发

目的研究胰液中K-ras12密码子点突变和血清CA19-9联合检测结果与胰腺癌病程的关系.方法测定32例临床及手术证实的胰腺癌患者血清CA19-9水平,同时采用内镜ERCP从胰管收集胰液标本,应用聚合酶链反应限制性片断长度多态性分析(PCR-RFLP)检测胰液K-ras基因12密码子点突变,分析K-ras12密码子点突变及血清CA19-9水平联合检测结果与胰腺癌临床特征和术后复发的关系.结果 (1)胰液中K-ras12密码子点突变率为56.3%,与肿瘤大小密切相关(P ＜ 0.05).K-ras12密码子点突变阳性、阴性表达病例3年复发率分别为66.7%和33.3%.(2)高血清CA19-9水平且K-ras12密码子点突变阳性组3年复发率为69.2%,而低血清CA19-9水平且K-ras12密码子点突变阴性组3年复发率为20.0%,两组差异显著(P ＜ 0.05).结论联合胰液中K-ras12密码子点突变和血清CA19-9检测可作为判断胰腺癌术后复发的有效指标,多因素分析对胰腺癌术后复发的判断更有价值.     

Evaluation of the diagnostic value of serum tumor markers,and fecal k‐ras and p53 gene mutations for pancreatic cancer

OBJECTIVE: To evaluate the diagnostic value for pancreatic cancer of four serum tumor markers, carbohydrate antigen (CA) 199, CA242, CA50 and carcino‐embryonic antigen (CEA), and fecal k‐ras and p53 gene mutations. METHODS: From February 2002 to March 2004, 136 patients were consecutively diagnosed with pancreatic cancer in the three participating medical centers. The diagnosis was confirmed by pathology in 53 patients, of whom five were excluded because they did not have measurement of serum tumor marker. The remaining 48 patients comprised the case group in the study. Ninety‐six patients with benign digestive diseases diagnosed during the same period were recruited as control subjects. They were matched by sex and age. In both groups, serum CA199, CA242, CA50 and CEA were measured by ELISA, and fecal k‐ras and p53 gene mutations were measured by PCR‐restriction fragment length polymorphism and PCR‐single strand conformational polymorphism, respectively. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to compare their diagnostic value, as well as the sensitivity, specificity and likelihood ratio. Moreover, independent and sensitive tests from these non‐invasive approaches were selected to form a parallel test that may have further improved sensitivity for diagnosis of pancreatic cancer. RESULTS: The AUC of serum CA199 and CA242 were 0.821 (95%CI 0.725–0.917) and 0.821 (95%CI 0.723–0.919), respectively. The optimal diagnostic value of serum CA199 for pancreatic cancer was 93 U/mL, with a sensitivity of 73.7% and specificity of 91.4%. The positive likelihood ratio of CA199 was 8.57, and the negative likelihood ratio was 0.29. The optimal diagnostic value of serum CA242 was 25 U/mL, with a sensitivity of 71.1% and specificity of 93.5%. The positive likelihood ratio of CA242 was 10.94, and the negative likelihood ratio was 0.31. The sensitivity of fecal k‐ras gene mutation for diagnosis of pancreatic cancer was 77.4%, and the specificity was 81.2%. The positive and negative likelihood ratios of fecal k‐ras gene mutation were 4.12 and 0.28, respectively. The sensitivity and specificity of fecal p53 gene mutation were 25.8% and 95.3%, respectively, and its positive and negative likelihood ratios were 5.49 and 0.78. The rate of fecal k‐ras mutation was higher in patients with benign pancreatic diseases (57.14%) than that of controls with non‐pancreatic disorders. The values of serum tumor markers and fecal k‐ras and p53 gene mutation rates were not significantly different in subgroups according to site or stage of pancreatic cancer. The sensitivity and specificity of the parallel test of serum CA199 and fecal k‐ras gene mutation were 94.06% and 74.22%, respectively, while the sensitivity and specificity of the parallel test of serum CA242 and fecal k‐ras were 93.47% and 75.92%, respectively. CONCLUSIONS: Serum CA199 and CA242 are valuable diagnostic tools for pancreatic cancer. The diagnostic value is further improved when they are combined with fecal k‐ras gene mutation measurement.     

胰腺癌患者血清中巨噬细胞因子-1、糖链抗原19-9、糖链抗原242及癌胚抗原的检测分析

目的 探讨血清巨噬细胞因子-1（MIC-1）、糖链抗原（CA）19-9 、CA242及癌胚抗原（CEA）在胰腺癌中的应用价值.方法 分析129例胰腺癌患者和120例健康体检者4项肿瘤标志物的检测结果,计算各肿瘤标志物组合方式对提高胰腺癌诊断的作用.结果 胰腺癌患者血清中各项肿瘤标志物的水平与对照组比较差异有统计学意义（P〈0.05）.MIC-1＋CA19-9组合的敏感性与单项检测敏感性最高的MIC-1比较,差异有统计学意义（P〈0.05）;MIC-1＋CA19-9组合的特异性与单项检测特异性最高的CA19-9比较,差异无统计学意义（P〉0.05）.Ⅲ~Ⅳ期胰腺癌患者血清CA19-9、CA242水平与Ⅰ~Ⅱ期比较,差异有统计学意义（P〈0.05）.结论 4项肿瘤标志物的检测对胰腺癌的诊断均有一定的价值,MIC-1＋CA19-9联合检测可提高诊断的敏感性,同时未降低其特异性.CA19-9、CA242对判断胰腺癌的预后有一定价值.     

胰液K-ras基因突变和血清CA19-9联合检测判断胰腺癌复发

目的研究胰液中K-ras12密码子点突变和血清CA19-9联合检测结果与胰腺癌病程的关系。方法测定32例临床及手术证实的胰腺癌患者血清CA19-9水平,同时采用内镜ERCP从胰管收集胰液标本,应用聚合酶链反应限制性片断长度多态性分析(PCR-RFLP)检测胰液K-ras基因12密码子点突变,分析K-ras12密码子点突变及血清CA19-9水平联合检测结果与胰腺癌临床特征和术后复发的关系。结果 (1)胰液中K-ras12密码子点突变率为56．3％,与肿瘤大小密切相关(P<0．05)。K-ras12密码子点突变阳性、阴性表达病例3年复发率分别为66．7％和33．3％。(2)高血清CA19-9水平且K-ras12密码子点突变阳性组3年复发率为69．2％,而低血清CA19-9水平且K-ras12密码子点突变阴性组3年复发率为20．0％,两组差异显著(P<0．05)。结论联合胰液中K-ras12密码子点突变和血清CA19-9检测可作为判断胰腺癌术后复发的有效指标,多因素分析对胰腺癌术后复发的判断更有价值。     

肿瘤标志物CA242与CA19-9对胰腺癌的诊断价值

目的:比较血清肿瘤标志物CA242与CA19-9对胰腺癌的诊断价值。方法:1996年4月至1997年6月,北京医院对门诊及住院197例患者进行了血清CA19-9的检测,148例进行了CA242的检测,其中25例为临床明确诊断为胰腺癌,12例为急性胰腺炎,18例为良性阻塞性黄疸。结果显示:胰腺癌患者血清CA19-9和CA242较对照明显增高,其中25例胰腺癌患者有21例CA19-9阳性,检测的灵敏度为84％,特异性为74.4％,有17例CA242阳性,检测的灵敏度为68％,特异性为87.8％。CA242与CA19-9比较,灵敏度无显著差异(0.10相似文献   

Clinical value of serum CA19-9 levels in evaluating resectability of pancreatic carcinoma

AIM： To evaluate the clinical value of serum CA19-9 levels in predicting the respectability of pancreatic carcinoma according to receiver operating characteristic （ROC） curve analysis.
METHODS： Serum CA19-9 levels were measured in 104 patients with pancreatic cancer which were possible to be resected according to the imaging. ROC curve was plotted for the CA19-9 levels. The point closest to the upper left-hand corner of the graph were chosen as the cut-off point. The sensitivity, specificity, positive and negative predictive values of CA19-9 at this cut-off point were calculated.
RESULTS： Resectable pancreatic cancer was detected in 58 （55.77%） patients and unresectable pancreatic cancer was detected in 46 （44.23%） patients. The area under the ROC curve was 0.918 and 95% CI was 0.843-0.992. The CA19-9 level was 353.15 U/mL, and the sensitivity and specificity of CA19-9 at this cutoff point were 93.1% and 78.3%, respectively. The positive and negative predictive value was 84.38% and 90%, respectively.
CONCLUSION： Preoperative serum CA19-9 level is a useful marker for further evaluating the resectability of pancreatic cancer. Obviously increased serum levels of CA19-9 （〉 353.15 U/mL） can be regarded as an ancillary parameter for unresectable pancreatic cancer.     

Comparison of tumor marker CA 242 with CA 19-9 and carcinoembryonic antigen (CEA) in pancreatic cancer

BACKGROUND/AIMS: Although there are a variety of tumor markers used for diagnosis of pancreatic carcinoma, the sensitivity and specificity of those markers have not yet reached an ideal level. The aim of this study was to compare the diagnostic value of CA 242 with CA 19-9 and CEA in the patients with pancreatic cancer. METHODOLOGY: Serum CA 242, CA 19-9 and CEA levels were determined in 135 subjects in the following groups: Pancreatic cancer (n = 40), cholangiocellular carcinoma (n = 15), hepatocellular carcinoma (n = 10), cirrhosis (n = 7), chronic active hepatitis (n = 7), choledochal stone (n = 12), chronic pancreatitis (n = 9), acute pancreatitis (n = 6), and healthy controls (n = 29). RESULTS: An elevated serum CA 242 concentration (> 20 U/mL) was found in 30 out of 40 (70%) (mean; 2163 +/- 838 U/mL) patients with pancreas cancer, in 11 out of 15 patients with cholangiocellular carcinoma (93.3%) (mean 916 +/- 529 U/mL), in none of patients with hepatocellular carcinoma and healthy controls. Slightly elevated CA 242 concentration was found in 6 out of 41 patients with benign hepatobiliary and pancreatic disease (range 0.4-97.8 U/mL) (1 acute pancreatitis, 2 chronic pancreatitis, 1 cirrhosis, 2 choledochal stone). Mean serum CA 242, CA 19-9 and CEA levels of the pancreas cancer group were significantly higher than those of the other groups except the cholangiocellular carcinoma group. There was no significant difference between the stage of pancreas cancer regarding mean serum CA 242, CA 19-9 and CEA level. There was positive correlation between serum CA 242 and CA 19-9 level. In the pancreas cancer, the sensitivity of CA 242, CA 19-9 and CEA was 75%, 80%, 40%, respectively and the specificity of those markers was 85.5%, 67.5% and 73%, respectively. CONCLUSIONS: In conclusion, the advantage of CA 242 compared to CA 19-9 is that its specificity is higher than that of CA 19-9 in the diagnosis of pancreas cancer.     

Serum level of TSGF, CA242 and CA19-9 in pancreatic cancer

AIM: To establish a method to detect the expression of the tumor specific growth factor TSGF, CA242 and CA19-9 in serum and evaluate their value in diagnosis of pancreatic cancer. METHODS: ELISA and Biochemical colorimetric assay were used to detect the serum content of TSGF, CA242 and CA19-9 in 200 normal cases, 52 pancreatitis patients and 96 pancreatic cancer patients. RESULTS: The positive likelihood ratios of TSGF, CA242 and CA19-9 were 5.4, 12.6 and 6.3, respectively, and their negative likelihood ratios were 0.10, 0.19 and 0.17, respectively. With single tumor marker diagnosed pancreatic cancer, the highest sensitivity and specificity of TSGF were 91.6% and 93.5%. In combined test with 3 markers, when all of them were positive, the sensitivity changed to 77.0% and the specificity and the positive predictive value were 100%. The levels of TSGF and CA242 were significantly higher in the patients with pancreatic cancer of head than those in the patients with pancreatic cancer of body, tail and whole pancreas, but the expression of CA19-9 had no correlation with the positions of the pancreatic cancer. The sensitivity of TSGF, CA242 and CA19-9 was increased with the progress in stages of pancreatic cancer. In stage I, the sensitivity of TSGF was markedly higher than CA242 and CA19-9. CONCLUSION: The combined use of TSGF, CA242 and CA19-9 expressions can elevate the specificity for pancreatic cancer diagnosis. And it shows that it plays an important role to differentiate positions and tissue typing. It is a forepart diagnosis for the pancreatic cancer by combination checking. There is very important correlation between the three markers and the pancreatic cancer.     

血清TSGF、CA242、CA19-9对老年胰腺癌患者诊断作用的临床研究

目的 评价血清中肿瘤标志物恶性肿瘤相关物质(TSGF)、糖类抗原CA242和CAl9-9对老年胰腺癌患者的诊断作用。方法 采用生化比色法与酶免法分别检测200例健康人、52例胰腺炎及96例胰腺癌患者的TSGF、CA242和CAl9-9含量。结果 TSGF、CA242和CAl9-9阳性似然比依次为5．4、12．6和6．3，阴性似然比依次为0．10、0．19和0．17。单项肿瘤标志物对胰腺癌诊断：TSGF敏感性高达91．6％，CA242特异性高达93．5％。以3项均为阳性诊断胰腺癌：敏感性为77．1％，特异性和阳性预测值皆为100．0％。胰头癌TSGF与CA242水平显著高于胰体癌、胰尾癌及全胰癌，而CAl9-9的表达与其部位无相关性。TSGF、CA242与CAl9-9随着临床分期的进展而敏感性增加，Ⅰ期者TSGF的敏感性显著高于CA242与CAl9-9，因此TSGF可以作为胰腺癌早期筛选的肿瘤标志物。结论 应用TSGF、CA242和CAl9-9联合诊断胰腺癌可以提高特异性，其表达对胰腺癌的不同组织分型起到重要作用，3项标志物联合检测可助早期诊断胰腺癌。