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.

Clinical research of serum MIC-1,CA19-9,CA242 and CEA in patients with pancreatic cancer

Objective To study the clinical values of serum MIC-1 ,CA19-9,CA242 and CEA in patients with pancreatic cancer. Methods The serum levels of MIC-1, CA19-9, CA242 and CEA were tested in129 pancreatic caneer patients confirmed by pathological diagnosis and 120 healthy controls. The detection roles of different combined markers were evaluated for improving the diagnostic rate of pancreatic cancer. Results The results showed the difference was significant between the pancreatic cancer patients and healthy controls in each serum level of these 4 tumor markers （ P 〈 0.05 ）. The sensitivity of MIC-1 alonewas the highest in the pancreatic cancers, but the sensitivity of combined detection of MIC-1 plus CA19-9 was significantly higher than that of MIC-1 alone（P 〈 0.05 ）. The specificity of CA19-9 alone was the highest in the pancreatic cancers, but there was no significant difference between the specificity of MIC-1 plus CA19-9） and MIC-1 alone（P 〉0.05）. The serum levels of CA19-9 and CA242 in stage III- IV patients were significantly higher than those in stage I - II patients （ P 〈 0.05 ）. Conclusion The measurements of serum MIC-1, CA19-9, CA242 and CEA are valuable for the diagnosis of pancreatic canc- er. Combined detection of MIC-1 plus CA19-9 can improve the diagnostic sensitivity. The measurements of serum CA19-9 and CA242 are valuable for evaluating the prognosis of pancreatic cancer.