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血清CA19-9水平在评估胰腺癌可切除性中的临床价值。

Clinical value of serum CA19-9 levels in evaluating resectability of pancreatic carcinoma.

作者信息

Zhang Shun, Wang Yi-Ming, Sun Chuan-Dong, Lu Yun, Wu Li-Qun

机构信息

Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China.

出版信息

World J Gastroenterol. 2008 Jun 21;14(23):3750-3. doi: 10.3748/wjg.14.3750.

Abstract

AIM

To evaluate the clinical value of serum CA19-9 levels in predicting the respectability of pancreatic carcinoma according to receiver operating characteristic (ROC) curve analysis.

METHODS

Serum CA19-9 levels were measured in 104 patients with pancreatic cancer which were possible to be resected according to the imaging. ROC curve was plotted for the CA19-9 levels. The point closest to the upper left-hand corner of the graph were chosen as the cut-off point. The sensitivity, specificity, positive and negative predictive values of CA19-9 at this cut-off point were calculated.

RESULTS

Resectable pancreatic cancer was detected in 58 (55.77%) patients and unresectable pancreatic cancer was detected in 46 (44.23%) patients. The area under the ROC curve was 0.918 and 95% CI was 0.843-0.992. The CA19-9 level was 353.15 U/mL, and the sensitivity and specificity of CA19-9 at this cut-off point were 93.1% and 78.3%, respectively. The positive and negative predictive value was 84.38% and 90%, respectively.

CONCLUSION

Preoperative serum CA19-9 level is a useful marker for further evaluating the resectability of pancreatic cancer. Obviously increased serum levels of CA19-9 (> 353.15 U/mL) can be regarded as an ancillary parameter for unresectable pancreatic cancer.

摘要

目的

通过受试者工作特征(ROC)曲线分析评估血清CA19-9水平在预测胰腺癌可切除性方面的临床价值。

方法

对104例根据影像学检查可能可切除的胰腺癌患者测定血清CA19-9水平。绘制CA19-9水平的ROC曲线。选择最接近图表左上角的点作为截断点。计算该截断点时CA19-9的敏感性、特异性、阳性预测值和阴性预测值。

结果

58例(55.77%)患者检测为可切除胰腺癌,46例(44.23%)患者检测为不可切除胰腺癌。ROC曲线下面积为0.918,95%可信区间为0.843 - 0.992。CA19-9水平为353.15 U/mL,该截断点时CA19-9的敏感性和特异性分别为93.1%和78.3%。阳性预测值和阴性预测值分别为84.38%和90%。

结论

术前血清CA19-9水平是进一步评估胰腺癌可切除性的有用标志物。血清CA19-9水平明显升高(>353.15 U/mL)可被视为不可切除胰腺癌的一个辅助参数。

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