巨噬细胞抑制因子1、再生基因4、糖类抗原19-9对胰腺癌的诊断价值比较
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摘要
目的通过与糖类抗原19-9(CA19-9)比较,探讨巨噬细胞抑制因子1(MIC-1)、再生基因4(REG-4)对胰腺癌的诊断价值。方法选择2013年7月至2015年7月南华大学附属第二医院收治的疑似胰腺癌患者70例。采用电化学发光仪检测标本中的CA19-9含量、酶联免疫吸附测定法分别测定MIC-1和REG-4含量,比较三者检测诊断胰腺癌的灵敏度、特异度、准确度、阳性预测值及阴性预测值。结果以病理检测为金标准,实际胰腺癌患者35例,胰腺良性肿瘤患者35例,CA19-9灵敏度为68.6%、特异度为54.3%、准确度为61.4%,阳性预测值为60.0%,阴性预测值为78.9%,MIC-1灵敏度为88.6%、特异度为77.1%、准确度为77.3%,阳性预测值为79.5%,阴性预测值为87.1%,REG-4灵敏度为91.4%、特异度为75.0%、准确度为80.0%,阳性预测值为78.0%,阴性预测值为90.0%。MIC-1、REG-4准确度均大于CA19-9。结论 MIC-1及REG-4胰腺癌患者诊断效力高于CA19-9。
Objective To compare the difference of macrophage inhibitory factor 1( MIC-1),regenerated gene 4( REG-4) and CA19-9 in the diagnosis of pancreatic cancer. Methods From July 2013 to July 2015,70 patients with suspected pancreatic cancer in Second Hospital Affiliated to Nanhua University were selected as study subjects. The concentration of CA19-9 were detected by electrochemiluminescence analyzer,while the concentration of MIC-1 and REG-4 were detected by ELISA respectively. The sensitivity,specificity,positive predictive rate and negative predictive rate of the diagnosis of pancreatic cancer were compared. Results Pathological examination was as gold standard,35 patients were pancreatic cancer and 35 patients were benign pancreatic tumors. CA19-9 sensitivity 68. 6%,specificity 54. 3%,accuracy61. 4%,positive predictive value 60. 0%,negtive predictive value 78. 9%,MIC-1 sensitivity 88. 6%,specificity 77. 1%,accuracy 77. 3%,positive predictive value 79. 5%,negtive predictive value 87. 1%,REG-4 sensitivity 91. 4%,specificity75. 0%,accuracy 80. 0%,positive predictive value 78. 0%,negtive value 90. 0%. By ROC curve analysis,the area under CA19-9,MIC-1 and REG-4 curves were. The accuracy of MIC-1,REG-4 were all more than that of CA19-9. Conclusion REG-4 and MIC-1 had a high diagnostic efficiency than CA19-9 in pancreatic cancer.
Objective To compare the difference of macrophage inhibitory factor 1( MIC-1),regenerated gene 4( REG-4) and CA19-9 in the diagnosis of pancreatic cancer. Methods From July 2013 to July 2015,70 patients with suspected pancreatic cancer in Second Hospital Affiliated to Nanhua University were selected as study subjects. The concentration of CA19-9 were detected by electrochemiluminescence analyzer,while the concentration of MIC-1 and REG-4 were detected by ELISA respectively. The sensitivity,specificity,positive predictive rate and negative predictive rate of the diagnosis of pancreatic cancer were compared. Results Pathological examination was as gold standard,35 patients were pancreatic cancer and 35 patients were benign pancreatic tumors. CA19-9 sensitivity 68. 6%,specificity 54. 3%,accuracy61. 4%,positive predictive value 60. 0%,negtive predictive value 78. 9%,MIC-1 sensitivity 88. 6%,specificity 77. 1%,accuracy 77. 3%,positive predictive value 79. 5%,negtive predictive value 87. 1%,REG-4 sensitivity 91. 4%,specificity75. 0%,accuracy 80. 0%,positive predictive value 78. 0%,negtive value 90. 0%. By ROC curve analysis,the area under CA19-9,MIC-1 and REG-4 curves were. The accuracy of MIC-1,REG-4 were all more than that of CA19-9. Conclusion REG-4 and MIC-1 had a high diagnostic efficiency than CA19-9 in pancreatic cancer.
引文
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[19]肖卫东,曾林山,胡伟,等.血清再生基因4检测在胰腺癌诊断中的作用[J].中华实验外科杂志,2013,30(5):1080.
[20]黄容旺,范文伟.血清胃蛋白酶原与再生基因Ⅳ联合检验对胃癌早期诊断的应用价值[J].重庆医学,2014,43(14):1755-1757.
[2]杨尹默,刘子文,赵玉沛,等.胰腺癌诊治指南(2014)[J].中国实用外科杂志,2014,34(1):1011-1017.
[3]罗国培,肖志文,刘祖强,等.胰腺癌淋巴转移诊治进展与处理规范[J].中国癌症杂志,2014,24(2):475-481.
[4]吴爱祝,梁茱,王海枫.胰腺癌患者血清中CA199、CA242、CA125、CEA检测分析[J].中国实验诊断学,2011,15(7):1087-1088.
[5]杨鹏,赵建勇,江建新.血清Try-2、CA199、CA125与胰腺癌的相关性研究[J].河北医学,2015,21(9):1413-1415.
[6]张帆.吉西他滨抑制人胰腺癌细胞增殖与诱导凋亡的研究[J].中国临床药理学杂志,2015,31(7):508-510.
[7]谢海林,陈芳.血清标志物检测在胰腺癌患者中的诊断价值[J].检验医学与临床,2017,14(14):2061-2063.
[8]何淑霞,杨娜,刘东红.血清CEA、CA19-9及铁蛋白联合检测在胰腺癌诊断中的价值[J].检验医学与临床,2015,12(6):803-804.
[9]杨晓莉.MIC-1、OPN及CA19-9联合检测对胰腺癌的诊断价值[J].世界华人消化杂志,2014,22(20):2966-2970.
[10]杨懿,蔡春祥.磁共振成像联合血清糖类抗原与癌胚抗原诊断胰腺癌的价值[J].临床医学研究与实践,2017,2(21):6-7.
[11]李海传.CT联合MRI在胰腺癌鉴别诊断中的应用价值研究[J].中国疗养医学,2015,24(11):1175-1176.
[12]张超,田海梅,李茉,等.巨噬细胞抑制因子-1及其联合多种标志物在肺癌早期诊断和诊断中的临床意义[J].癌症进展,2015,8(3):306-311.
[13]刘俊.联合检测血清癌胚抗原糖类抗原19-9糖类抗原242在胰腺癌诊断中的价值[J].中国药物与临床,2013,13(7):932-933.
[14]刘晓敏,王新芹,刘东声.血清糖类抗原19-9糖类抗原125和胱抑素C在胰腺癌诊断中的临床意义[J].实用医技杂志,2013,20(10):1088-1089.
[15]陶光丽,任传路,丁庆莉.巨噬细胞抑制因子-1、恶性肿瘤生长因子与CA19-9联合检测对胰腺癌的临床诊断价值[J].检验医学与临床,2015,12(2):215-216.
[16]任秀慧.MIC-1、OPN及CA19-9联合检测在诊断胰腺癌患者中的应用价值[J].国际医药卫生导报,2017,23(12):1934-1936.
[17]王小兵,付超,吴凡,等.胰腺癌患者血清中巨噬细胞抑制因子-1的大样本临床研究[J].癌症进展,2011,9(4):367-373.
[18]刘祖宏,倪仰鹏,黄绮国,等.RegⅣ在胃癌中的表达及临床意义[J].现代肿瘤医学,2013,21(7):1550-1551.
[19]肖卫东,曾林山,胡伟,等.血清再生基因4检测在胰腺癌诊断中的作用[J].中华实验外科杂志,2013,30(5):1080.
[20]黄容旺,范文伟.血清胃蛋白酶原与再生基因Ⅳ联合检验对胃癌早期诊断的应用价值[J].重庆医学,2014,43(14):1755-1757.