不同肿瘤与并发胰腺炎患者血清AMY和LPS的分布水平及实验诊断价值研究

目的探讨不同肿瘤患者血清淀粉酶(amylase，AMY)和脂 肪酶(lipase，LPS)水平，以及AMY和LPS诊断肿瘤患者胰腺炎的价值，为临床医生诊断或排 除肿瘤病人胰腺炎提供实验室依据。方法收集四川省肿瘤医院2018 年1月~2018年6月体检健康人群49例，肿瘤病人80例，另外收集胰腺炎患者6例和肿瘤并发胰 腺炎患者16例。检测所有纳入人群的AMY和LPS并进行统计分析，同时利用ROC曲线分析诊断 价值。结果肿瘤患者的AMY(109.78±136.04 U/L)高于健康对照( 77.67±26.97 U/L)，且肿瘤患者的LPS(64.35±70.80 U/L)也高于健康对照(36.43±2 1.71 U/L)，差异均具有统计学意义( t=2.046，3.284，均P ＜0.05)。肺癌患者的AN Y(183.43±210.32 U/L)高于健康对照，卵巢癌的LPS(111.57±109.88 U/L)高于健康对 照，差异具有统计学意义( t =1.329，1.804，均 P ＜0.05)。AMY诊断非肿瘤人群 的胰腺炎患者的AUC为0.993，诊断肿瘤人群的胰腺炎患者的AUC为0.864。LPS诊断非肿瘤 人群的胰腺炎患者的AUC为1.000，诊断肿瘤人群的胰腺炎患者的AUC为0.982。 结论血清AMY和LPS水平在肿瘤人群中显著升高，可能导致胰腺炎的误诊。

Distributions and Diagnostic Values of Serum Amylase and Lipase in Patients with Various Types of Tumors and Those with Pancreatitis

Objective To investigate the level of serum amy lase(AMY) and lipase(LPS) in patients with various types of tumors，and explore the diagnostic value of the two items in cancer patients’ pancreatitis in order to prov ide laboratory basis for clinicians diagnosing or excluding pancreatitis in canc er patients．Methods A total of 49 healthy people and 80 cancer patients were enrolled．In addition，6 pancreatitis patients without canc er and 16 pancreatitis patients with cancer were enrolled．The serum AMY and LPS were detected．All the data were analyzed statistically．The ROC curves were us ed to evaluate the diagnostic value of amylase and LPS in cancer patients． Results The level of AMY in cancer patients (109.78±136.04 U/L) was higher than the healthy people (77.67±26.97 U/L) the difference was statistically significant ( t=2.046，P ＜0.05)．The level of LPS in cancer p atients (64.35±70.80 U/L) was also higher than healthy　people (36.43±21.7 1 U/L) the difference was statistically significant ( t=3.284，P ＜0.05)．Th e amylase of lung cancer patients (183.43±210.32 U/L) was higher than healthy people ( t=1.329，P ＜0.05)．The LPS of ovarian cancer was higher than heal thy people ( t=1.804，P ＜0.05)．When used to diagnose the pancreatitis pati ents without cancer，the AUC of AMY and LPS were 0.993 and 1.000 respectively ．When used to diagnose the pancreatitis patients with cancer，the AUC of AMY an d LPS were 0.864 and 0.982 respectively．Conclusion The level of serum AMY and LPS were significantly elevated in cancer patients，whic h might cause the misdiagnosis and miss-diagnosis of pancreatitis in cancer pat ients．