摘要
目的探讨糖类抗原199(CA199)、糖类抗原CA242(CA242)、分泌型蛋白Dickkopf-1(DKK1)对胰腺癌的诊断价值。方法应用电化学发光免疫分析法和酶联免疫吸附测定法(ELISA)检测112例胰腺癌和58例胰腺良性疾病组及62例体检健康者血清CA199、CA242和DKK1水平,采用Kruskal-Wallis单因素方差分析与Mann-Whitney秩和检验进行统计学比较,Logistic回归模型绘制ROC曲线并计算曲线下面积(AUCROC)以评价各指标的诊断价值。结果胰腺癌患者血清CA199、CA242和DKK1水平明显高于胰腺良性疾病组及健康对照组,差异有统计学意义(H值分别为76.30、61.2、47.60,P<0.05);CA199、CA242和DKK1对胰腺癌诊断的敏感度分别为76.7%、69.6%、85.7%,特异度分别为95.0%、96.7%、92.5%,准确度分别为86.2%、83.6%、89.2%,3项指标运用回归方程P=1/[1+e-(-4.163+0.21 X1+0.156 X2+0.342 X3)]综合分析诊断胰腺癌,敏感度、特异度和准确度分别为94.4%、90.8%、92.2%;CA199、CA242、DKK1及pre-1的ROC曲线下面积分别为0.736、0.862、0.886、0.949。结论检测血清CA199、CA242和DKK1水平对胰腺癌的诊断具有重要的价值,3种标志物联合检测能明显提高胰腺癌诊断的敏感度和准确度。
Objective To investigate the clinical values of CA199,CA242 and DKK1in diagnosing pancreatic cancer（PCA）.Methods The serum levels of CA199,CA242 and DKK1 were measured with ECLIA and ELISA method in 112 patients with PCA,58 patients with benign pancreatic disease and 62 individuals undergoing physical examination.The Kruskal-Wallis single factor analysis of variance（ANOVA）and Mann-Whitney rank-sum test were adopted to conduct the statistical comparison.The ROC curve was drawn by using the Logistic regression model and the area under curve（AUCROC）was calculated.Results The levels of serum CA199,CA242 and DKK1in the patients with pancreatic cancer were significantly higher than those in the benign pancreatic disease group and healthy normal control group,the difference was statistically significant（H=76.30,61.2,47.60,P〈0.05）;the sensitivities of CA199,CA242 and DKK1for diagnosing pancreatic cancer were 76.7%,69.6% and 85.7% respectively;the specificities were 95.0%,96.7% and 92.5% respectively;the accuracies were 86.2%,83.6% and 89.2% respectively.The sensitivity,specificity and accuracy of combined detection of CA199,CA242 and DKK1 by the Logistic regression equation P =1/[1＋e-（-4.163＋0.21 X1＋0.156 X2＋0.342 X3）]were 94.4%,90.8% and 92.2% respectively;AUC of CA199,CA242,DKK1 and pre-1were 0.736,0.862,0.886 and 0.949,respectively.Conclusion Serum CA199,CA242 and DKK1levels have an important value in the diagnosis of pancreatic cancer,and their combined detection could significantly improve the sensitivity and accuracy of pancreatic cancer diagnosis.
出处
《国际检验医学杂志》
CAS
2017年第4期496-499,共4页
International Journal of Laboratory Medicine
关键词
胰腺癌
糖类抗原
分泌型蛋白
受试者工作曲线
pancreatic cancer
carbohydrate antigen
secreted protein
receiver operating characteristic curve
