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目的:探讨术前血清肿瘤标记物糖类抗原(CA19-9、CA50、CA242、CA125)和癌胚抗原(CEA)水平对胰头癌可切除性评估的临床价值。方法:回顾性分析2014年1月—2015年12月收治的104例胰头癌患者的临床资料,筛选与胰头癌可切除性相关的血清肿瘤标记物,并采用受试者工作特性曲线(ROC)与曲线下面积(AUC)分析其对胰头癌可切除性的预测价值。结果:104例患者均行手术探查,其中可切除54例(可切除组),不可切除50例(不可切除组)。两组术前血清CA50和CEA水平差异无统计学意义(均P>0.05),而不可切除组CA19-9、CA242和CA125水平明显高于可切除组(317.99k U/Lvs.152.98k U/L;67.81k U/Lvs.39.36k U/L;71.53k U/Lvs.29.22k U/L,均P<0.05)。ROC分析得出CA19-9和CA125对胰头癌可切除性均具有判断价值,其最佳截断点分别为236.13k U/L和16.44k U/L,AUC值分别为0.667和0.678(均P<0.05),而单项检测CA242对胰头癌可切除性诊断无明显判别价值(AUC=0.609,P=0.085)。CA19-9、CA125联合诊断对胰头癌可切除性诊断的灵敏度和特异性提高。结论:术前检测血清CA19-9和CA125水平可作为辅助指标应用于胰头癌的可切除性评估,两者联合检测更能提高灵敏度和特异性。
Objective: To evaluate the clinical value of preoperative serum tumor marker carbohydrate antigen (CA19-9, CA50, CA242, CA125) and carcinoembryonic antigen (CEA) in assessing resectability of pancreatic cancer. Methods: The clinical data of 104 patients with pancreatic head cancer who were treated from January 2014 to December 2015 were retrospectively analyzed. Serum tumor markers related to the resectability of pancreatic head cancer were screened. The patients’ working characteristic curve ( ROC) and the area under the curve (AUC) were analyzed for predicting the resectability of pancreatic head cancer. RESULTS: All 104 patients underwent surgical exploration, of which resection was performed in 54 cases (resectable group) and unresectable in 50 cases (unresectable group). There was no significant difference in preoperative serum levels of CA50 and CEA between the two groups (all P> 0.05), while the levels of CA19-9, CA242 and CA125 in unresectable group were significantly higher than those in resectable group (317.99 kU / L vs 152.98 kU / L; 67.81k U / Lvs.39.36k U / L; 71.53k U / Lvs.29.22k U / L, all P <0.05). ROC analysis showed that CA19-9 and CA125 were of diagnostic value for resectability of pancreatic cancer, with the best cut-off points of 236.13 kU / L and 16.44 kU / L, respectively. The AUC values were 0.667 and 0.678 <0.05). However, there was no significant difference between the single detection of CA242 and the diagnosis of resectability of pancreatic head cancer (AUC = 0.609, P = 0.085). CA19-9, CA125 joint diagnosis of resectability of pancreatic cancer sensitivity and specificity of the diagnosis. Conclusion: The preoperative serum CA19-9 and CA125 level can be used as an auxiliary index in the resectability assessment of pancreatic head cancer. The combined detection of them can improve the sensitivity and specificity.