摘要
目的探讨胰腺癌时CA19-9升高与血管侵犯的关系,应用受试者工作特征(ROC)曲线为CA19-9的临床应用提供更有力的理论支持。方法将经病理证实的我院222例胰腺癌患者分为血管侵犯组和未侵犯组。首先以常规统计学方法比较两组间的CA19-9水平是否具有差异,其次通过ROC曲线进一步评估CA19-9的应用价值,最后比较CA19-9与CA125及CA242的临床价值。结果(1)在血管侵犯发生者中,CA19-9平均为294.6±37.9u/ml,而无血管侵犯者CA19-9平均水平为185.6±23.9u/ml,两者具有显著差异(P=0.016)。(2)CA19-9诊断胰腺癌血管侵犯的ROC曲线下面积为0.641。当CA19-9大于500u/ml时,其判断血管侵犯的特异性高达95%。(3)CA125与CA242的ROC曲线下面积分别为0.562和0.618。结论CA19-9的水平与肿瘤是否发生血性转移有一定关系,CA19-9在常用血清标志物中较CA125与CA242中诊断价值更高。通过ROC曲线可确知当CA19-9大于500u/ml时,判断肿瘤转移的特异性高达95%以上,这为CA19-9的应用提供了一定的临床支持,同时显示ROC曲线在诊断试验中较常用的方法敏感性和特异性更为优越,能够提供更多的信息。
Objective To investigate the diagnostic value of CA19-9 to the vessel invasion of pancreatic carcinoma by ROC curve. Methods 222 patients of pancreatic carcinoma were divided into two groups by the occurrence of vessel invasion or not. Compare the level of serum CA19-9 between these two groups and assess the value by ROC curve finally,CA125 and CA242 were compared to CA19-9 in the diagnostic value of vessel invasion. Results The serum level of CA19-9 was higher in the vessel invasion group than another group（294.6 ± 37.9 u/ml vs 185.6 ± 23.9 u/ml, P = 0. 016）. In this test, the area of ROC curve is 0.641, higher than that of CA125 （0. 562 ） and CA242 （0.618 ）. In addition, the specificity is above 95 % in the diagnosis of vessel invasion while serum level of CA19-9 is 500 u/ml or more. Conclusion Serum level of CA19-9 may relate to the occurrence of vessel invason. Possibly CA19-9 is the best serum marker in this test and when its level is beyond 500 u/ml, the specificity can get to 95%. ROC curve is better because it can offer more information than sensitivity and specificity.
出处
《临床消化病杂志》
2010年第2期110-112,共3页
Chinese Journal of Clinical Gastroenterology
关键词
胰腺癌
ROC曲线
支持血管
Pancreatic carcinoma
ROC curre
Blood vessel
