血清TSGF、CA242、CA19-9对老年胰腺癌患者诊断作用的临床研究

目的 评价血清中肿瘤标志物恶性肿瘤相关物质(TSGF)、糖类抗原CA242和CAl9-9对老年胰腺癌患者的诊断作用。方法 采用生化比色法与酶免法分别检测200例健康人、52例胰腺炎及96例胰腺癌患者的TSGF、CA242和CAl9-9含量。结果 TSGF、CA242和CAl9-9阳性似然比依次为5．4、12．6和6．3，阴性似然比依次为0．10、0．19和0．17。单项肿瘤标志物对胰腺癌诊断：TSGF敏感性高达91．6％，CA242特异性高达93．5％。以3项均为阳性诊断胰腺癌：敏感性为77．1％，特异性和阳性预测值皆为100．0％。胰头癌TSGF与CA242水平显著高于胰体癌、胰尾癌及全胰癌，而CAl9-9的表达与其部位无相关性。TSGF、CA242与CAl9-9随着临床分期的进展而敏感性增加，Ⅰ期者TSGF的敏感性显著高于CA242与CAl9-9，因此TSGF可以作为胰腺癌早期筛选的肿瘤标志物。结论 应用TSGF、CA242和CAl9-9联合诊断胰腺癌可以提高特异性，其表达对胰腺癌的不同组织分型起到重要作用，3项标志物联合检测可助早期诊断胰腺癌。

Evaluation of serum TSGF, CA242 and CA19-9 in the diagnosis of pancreatic cancer in the elderly patients

Objective To evaluate the significance of serum TSGF, CA242 and CA19-9 level in diagnosing the pancreatic cancer in elderly patients. Methods The content of TSGF, CA242 and CA19-9 in 200 normal controls, 52 pancreatitis patients and 96 pancreatic cancer patients were determined with colorimctric of biochemistry and ELISA. Results The results displayed that positive likelihood ratio of priority of TSGF, CA242 and CA19-9 was 5.4, 12.6 and 6.3, and the negative likelihood ratio of priority was 0. 10, 0. 19 and 0. 17, respectively. The sensitivity and specificity of TSGF as a single tumor marker for diagnosing the pancreatic cancer were as high as 91. 6% and 93. 5%, respectively. If all three positive markers were used as a diagnositic standard for the pancreatic cancer, the sensitivity was 77. 1% and the specificity was 100. 0%. The expression of TSGF and CA242 in patients with the pancreatic head carcinoma was significantly higher than those in patients with the pancreatic body or tail carcinoma, but CA19-9 expression showed no relation with the location of the cancer. The sensitivity of TSGF, CA242 and CA19-9 was increased with the progress of the carcinoma. The level of TSGF in stage I cancer was significantly higher than CA242 and CA19-9. Therefore, TSGF was regarded as a tumor marker in early pancreatic cancer. Conclusions The application of TSGF, CA242 and CA19-9 can enhance their specificity in diagnosing the pancreatic carcinoma. Their expression is important in different histological typing. The combination of these 3 indicators are helpful in the early diagnosis.