胰腺癌患者血清细胞质胸腺激酶1及肿瘤标志物水平变化及其临床意义

目的探讨胰腺癌患者血清细胞质胸腺激酶1(TK1)、癌胚抗原(CEA)、糖链抗原19-9(CA19-9)、糖链抗原72-4(CA72-4)水平变化及其临床意义。方法我院诊治的胰腺癌患者75例(胰腺癌组)和40例良性胰腺疾病患者(良性组),同期体检健康志愿者35例(对照组)。检测各组血清TK1、CEA、CA19-9、CA72-4水平,根据血清TK1、CEA、CA19-9、CA72-4检测(串联)结果分为联合检测阳性组(n=49)和联合检测阴性组(n=26),依据患者预后情况分为预后良好组(n=24)、预后不良组(n=51)。比较各组血清TK1、CEA、CA19-9、CA72-4水平,ROC曲线分析四项指标联合检测对胰腺癌患者预后的预测价值。结果与对照组比较,胰腺癌组、良性组血清TK1、CEA、CA19-9、CA72-4水平明显增高,且胰腺癌组高于良性组(P<0.05)。联合检测阳性组临床分期为Ⅳ期、分化程度为低分化的占比高于联合检测阴性组(P<0.05)。预后不良组血清TK1、CEA、CA19-9、CA72-4水平高于预后良好组(P<0.05)。TK1、CEA、CA19-9、CA72-4水平联合检测诊断胰腺癌患者预后的ROC曲线下面积、灵敏度均较四项指标单独检测的高。结论胰腺癌患者血清TK1、CEA、CA19-9、CA72-4水平呈明显升高趋势,且四项指标联合检测对胰腺癌患者预后的预测价值较高,有望为胰腺癌患者预后的改善提供理论参考。

The clinical significance of changes in the levels of serum TK1 and tumor marker in patients with pancreatic cancer

Objective To investigate the clinical significance of changes in the levels of serum cytoplasmic thymidine kinase1(TK1),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and carbohydrate antigen 72-4(CA72-4)in patients with pancreatic cancer.Methods Seventy five patients with pancreatic cancer(pancreatic cancer group)and 40 patients with benign pancreatic disease(benign group)were enrolled in this study.Meanwhile,35 healthy volunteers were selected as control group.Serum levels of TK1,CEA,CA19-9 and CA72-4 in each group were detected.Patients with pancreatic cancer were further divided into combined detection positive subgroup(n=49)and combined detection negative subgroup(n=26)according to the detection results(in series)of these indexes.The cancer patients were also further divided into good prognosis group(n=24)and poor prognosis group(n=51)according to their prognosis.The levels of serum TK1,CEA,CA19-9 and CA72-4 were compared between the groups.ROC curve analysis was used to analyze the prognostic value of the combination of the four indexes in pancreatic cancer.Results Compared with the control group,the pancreatic cancer group and the benign group had significantly higher serum levels of TK1,CEA,CA19-9 and CA72-4,and the pancreatic cancer group had significantly higher levels than the benign group(P<0.05).The proportions of clinical stage IV and poor differentiation were significantly higher in the combined detection positive group than in the combined detection negative group(P<0.05).The poor prognosis group had significantly higher serum levels of TK1,CEA,CA19-9 and CA72-4 than those in the good prognosis group(P<0.05).The area under the ROC curve and sensitivity of the combined detection of TK1,CEA,CA19-9 and CA72-4 levels were higher than those of each index alone.Conclusion Patients with pancreatic cancer have significantly higher serum levels of TK1,CEA,CA19-9 and CA72-4.Combined detection of the four indexes has high predictive value for the prognosis of patients with pancreatic cancer,which is expected to provide theoretical reference for improving the prognosis of patients with pancreatic cancer.