血清肿瘤标志物和肝功能指标联合检测在胰腺癌肝转移诊断中的价值

摘要

目的 探讨肿瘤标志物和肝功能指标联合检测在胰腺癌肝转移早期诊断中的临床价值.方法 选取125例胰腺癌患者,其中肝转移58例,无肝转移67例.检测患者血清肿瘤标志物和肝功能指标水平,并对结果进行分析.结果 胰腺癌肝转移者血清中癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原242(CA242)和乳酸脱氢酶(LDH)水平显著高于无肝转移者(P＜0.05).ROC曲线分析显示CEA、CA19-9、CA242与LDH诊断肝转移的最佳上限为6.0μg/L、842 U/ml、64.48U/L与220 U/L.CEA和LDH单独检测肝转移的敏感性为64.2%和51.9%,特异性为71.4%和74.2%.而CEA与LDH联合检测的敏感性和特异性为77.6%和93.5%.结论 肿瘤标志物和肝功能指标联合检测特异性高,有助于胰腺癌肝转移的早期诊断.%Objective To explore the predictive ability of tumor markers and liver biochemical markers for assessing liver metastasis in patients with pancreatic cancer. Methods The levels of serum tumor markers and liver biochemical markers in 125 patients ( 58 with liver metastasis,and 67 without)with pancreatic cancer were analyzed. Results For the patients with liver metastasis, the levels of CEA, CA19-9, CA242 and LDH were significantly higher than those for patients without liver metastasis ( P ＜ 0.05 ). The best cut-off points for CEA, CA19-9, CA242 and LDH to predict liver metastasis were 6.0 ug/L, 842 U/ml, 64 U/ml and 220 U/L, respectively. The sensitivity of CEA and LDH was 64.2％ and 51.9％, and the specificity was 71.4％ and 74.2％. The sensitivity and specificity of co-detection of CEA and LDH was 77.6％ and 93.5％. Conclusion The co-detection of tumor marker with the biochemical marker for liver has satisfactory sensitivity and specificity for screening pancreatic liver metastasis.