摘要
目的通过检测胆管癌、良性胆管疾病患者和健康人血液中的肿瘤标志物糖类抗原199(CA199)、癌胚抗原(CEA)和循环游离DNA(cfDNA)的水平,探讨联合检测以上3项指标在胆管癌的诊断中的辅助价值。方法收集2018年1月至2019年8月间哈尔滨医科大学附属肿瘤医院和牡丹江医学院附属红旗医院就诊的45例胆管癌患者、40例良性胆管疾病患者和45例健康人的血清和血浆。用化学发光法检测三组人群的血清肿瘤标志物CA199、CEA的水平;用实时荧光定量PCR的方法定量检测三组人群血浆中的cfDNA的水平。分析以上3个指标在三组人群中的表达水平差异;采用ROC曲线分析法比较3种血液分子标志物单独及联合检测在胆管癌中的诊断价值。结果胆管癌患者血清CA199水平和血浆cfDNA水平明显高于良性胆管疾病组和健康人组(P<0.05),CEA水平与良性胆管疾病组和健康人组没有统计学差异(P>0.05);良性胆管疾病组CA199和CEA和cfDNA水平与健康人比较,差异均没有统计学意义。ROC曲线显示,联合检测CA199、CEA和cfDNA的诊断敏感性和曲线下面积(AUC)均明显高于单独检测这3种肿瘤标志物的结果,联合检测的特异性均高于CA199和CEA单独检测的特异性,但低于cfDNA单独检测的特异性。由于CA199和CEA两项指标的参考值已知,计算出的cfDNA临床截断点(cut-off值或临界值)为18.06 ng/mL。结论与单独检测相比较,联合检测血液中CA199、CEA和cfDNA对于诊断胆管癌有更高的辅助价值。
Objective To explore the value of combined detection of carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA)and circulating free DNA(cfDNA)in the blood in the diagnosis and prognosis of cholangiocarcinoma patients.Methods From January 2018 to August 2019,45 patients with cholangiocarcinoma who had not been treated,40 patients with benign bile duct disease and 45 healthy persons in Harbin Medical University Cancer Hospital and Hongqi Hospital affiliated with Mudanjiang Medical University were selected,and preoperative serum and plasma were collected.The levels of serum tumor markers CA199 and CEA were detected by chemiluminescence method,and the level of cfDNA in plasma was quantitatively detected by real-time fluorescent quantitative PCR.Statistical software analyzes the differences in the expression levels of the above three indicators in the three groups of people.The receiver operating curve(ROC curve)analysis method was used to compare the diagnostic value of the three blood molecular markers alone and jointly.Results Serum CA199 levels and plasma cfDNA levels in cholangiocarcinoma patients were significantly higher than those in benign bile duct disease group and healthy people group(P<0.05).The ROC curve of single detection and combined detection was drawn.The diagnostic sensitivity and area under the curve(AUC)of combined detection of CA199,CEA and cfDNA were significantly higher than the results of the detection of these three tumor markers alone.The specificity of the combined detection was higher than that of CA199 and CEA alone,but lower than the specificity of cfDNA alone.Since the reference values of the two indicators CA199 and CEA were known,the calculated clinical cut-off point(cut-off value or cut-off value)of cfDNA was 18.06 ng/mL.Conclusion Combined detection of CA199,CEA and cfDNA in blood has a higher diagnostic efficiency for the diagnosis of cholangiocarcinoma compared with the separate test.
作者
莫迪
李梦雨
李华洋
王志龙
李丽娟
金红
MO Di(First Clinical Medical College of Mudanjiang Medical University,Mudanjiang 157011,China)
出处
《牡丹江医学院学报》
2020年第3期18-21,共4页
Journal of Mudanjiang Medical University
基金
红旗科研基金(2018HQ-03)
牡丹江医学院研究生创新科研项目基金(2018YJSCX-29MY)。
