摘要
目的探究多排螺旋CT联合血浆糖类抗原199(CA199)、糖类抗原242(CA242)、糖类抗原50(CA50)对胰腺癌诊断准确性的分析。方法对该院收治的77例胰腺病变患者进行研究,均经手术病理证实,胰腺癌48例,胰腺良性病变例29例,所有患者均进行CT检测,采用免疫放射法对血浆中CA199、CA50、CA242水平进行检测,以手术病理诊断结果为金标准,对比两组患者血浆CA199、CA50、CA242水平、CT检测结果及单项检测诊断效能。结果良性组CT诊断阳性8例,胰腺癌组39例阳性,整体阳性检出率为61.04%,与手术病理结果对比符合率为77.92%。胰腺癌组血浆CA199、CA50、CA242水平高于良性组,差异有统计学意义(P<0.05);CA199检测符合率最高为75.32%,CA242检测符合率最低为45.75%。与单项血浆CA199、CA50、CA242检测相比,联合诊断准确度、灵敏度升高,漏诊率降低,差异有统计学意义(P<0.05);联合检测诊断准确度、灵敏度稍高于CT检测,但差异无统计学意义(P>0.05);不同诊断方式特异度、误诊率相比,差异无统计学意义(P>0.05)。结论多排螺旋CT诊断胰腺癌准确度及灵敏度较高,但联合血浆CA199、CA50、CA242检测可进一步提高诊断诊断效能,为临床治疗胰腺癌提供一定的参考。
Objective To explore the influence of Multi-slice spiral CT combined with plasma carbohydrate antigen 199（CA199）,carbohydrate antigen 242（CA242）,carbohydrate antigen 50（CA50）levels detection on diagnostic accuracy of pancreatic cancer.Methods 77 cases of patients with pancreatic lesion treated in our hospital were studied,and all were confirmed by surgery,there were 48 cases of pancreatic carcinoma,29 cases of pancreatic benign diseases.All the patients were undergoing CT testing.Plasma CA199,CA50 and CA242 levels were detected by using Radioimmunoassay method,and plasma CA199,CA50,CA242 levels,CT test results,and the efficacy of single test diagnosis were contrasted.Results After CT diagnosis,there were 8 cases positive in the benign group,39 cases positive in the pancreatic cancer group,with the overall positive rate of61.04%,and the coincidence rate was 77.92% when compared with the operation and pathological results.Plasma CA199,CA50 and CA242 in the pancreatic cancer group were higher than those in the benign group,the difference was statistically significant（P〈0.05）.Surgical pathological diagnosis was as the gold standard,the coincidence rate of CA199 was 75.32%in the highest,and the coincidence rate of CA242 was 45.75%in the lowest.Compared with those in the single plasma CA199,CA50,CA242 detection,the accuracy and sensitivity of combined diagnosis,and missed diagnosis rate decreased,the difference was statistically significant（P〈0.05）.Those were slightly higher than those of CT detection,but without statistically significant difference（P〉0.05）.There was no significant difference in specificity and misdiagnosis rate among different diagnostic ways（P〉0.05）.Conclusion The accuracy and sensitivity of multi-slice spiral CT is higher in diagnosis of pancreatic cancer,but combined detection of plasma CA199,CA50 and CA242 can further improve diagnosis efficiency,and provide a reference for clinical treatment of pancreatic cancer.
作者
胡波
张川
王浩
朱杰
顾国强
HU Bo;ZHANG Chuan;WANG Hao;ZHU Jie;GU Guoqiang(Department of Radiology,Central Hospital of Minhang District,Shanghai 201100,China)
出处
《国际检验医学杂志》
CAS
2018年第13期1582-1585,1589,共5页
International Journal of Laboratory Medicine
基金
上海市科学技术委员会科研计划项目(13ZR1408612)
关键词
胰腺癌
多排螺旋CT
糖类抗原
诊断效能
pancreatic cancer
multi slice helical CT
carbohydrate antigen
diagnostic efficacy
