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目的探讨胰腺癌患者血清中组织多肽特异性抗原(TPS)、癌抗原199(CA199)、癌抗原242(CA242)和癌胚抗原(CEA)水平,对胰腺癌的临床诊断、病情监控的临床意义。方法用ELISA检测80例胰腺癌和80例胰腺良性疾病患者及200例健康对照者血清TPS水平;同时用电化学发光法检测血清CEA、CA199及CA242的水平。并用约登指数分析4项肿瘤标志物及各项肿瘤标志物联合检测胰腺癌患者的效能。结果胰腺癌组的TPS、CEA、CA199及CA242水平明显高于胰腺良性疾病组和健康对照组(Z>1.9,P<0.01);广泛期胰腺癌患者的血清TPS和CA199明显高于局限期患者(Z=2.59、2.17,P均<0.05)。治疗后不同预后患者的TPS和CA199浓度差异有统计学意义(Z=2.69、2.59,P均<0.05)。多项指标联合检测时以TPS+CA199的敏感度最高(89.6%),其特异性、阳性预测值和阴性预测值分别为80.0%、81.8%、88.1%。结论血清TPS、CA199、CA242、CEA均可作为胰腺癌的诊断指标,以TPS+CA199联合检测的临床价值最好。
Objective To investigate the clinical significance of serum TPS, CA199, CA242 and CEA in the diagnosis of pancreatic cancer and its clinical significance . Methods Serum TPS levels were measured by ELISA in 80 patients with pancreatic cancer and 80 patients with benign pancreatic diseases and 200 healthy controls. The levels of serum CEA, CA199 and CA242 were also detected by electrochemiluminescence. And using the Youden index analysis of four tumor markers and various tumor markers combined detection of pancreatic cancer patients. Results The levels of TPS, CEA, CA199 and CA242 in pancreatic cancer group were significantly higher than those in benign pancreatic disease group and healthy control group (Z> 1.9, P <0.01). The serum levels of TPS and CA199 in patients with pancreatic cancer were significantly higher than those in patients with limited stage (Z = 2.59,2.17, P <0.05). The difference of TPS and CA199 in patients with different prognosis after treatment was statistically significant (Z = 2.69,2.59, P <0.05). The sensitivity, specificity, positive predictive value and negative predictive value of TPS + CA199 were the highest (89.6%) and the negative predictive value were 80.0%, 81.8% and 88.1% when combined testing. Conclusion Serum TPS, CA199, CA242, CEA can be used as a diagnostic indicator of pancreatic cancer, TPS + CA199 joint detection of the best clinical value.