作者：刘家栋，张婷

单位：鄂东医疗集团黄石市中心医院 检验科，湖北 黄石 435000

Authors:  LIU Jiadong, ZHANG Ting

Unit:  Department of Clinical laboratory, Huangshi Central Hospital, Edong Healthcare Group, Huangshi 435000, Hubei, China

摘要：

目的  分析血清LDH, CA19-9, CRP联合检测与胰腺癌预后的相关性。方法  回顾性分析2012年4月至2014年4月于我院接受治疗的130例胰腺癌患者的临床病理资料,患者均于治疗前检测血清乳酸脱氢酶(Lactate dehydrogenase, LDH)、癌抗原19-9(cancer antigen 19-9, CA19-9)、C反应蛋白(C-reactive protein, CRP)的表达水平,研究血清LDH、CA19-9、CRP联合检测与胰腺癌患者临床病理因素及预后的关系。结果  血清LDH、CA19-9、CRP表达增高患者的TNM分期Ⅲ、Ⅳ期患者的比例更高(53/61; 67/72; 61/68)(P<0.05),淋巴结有侵犯患者的比例更高(48/61; 50/72; 46/68)(P<0.05);血清LDH, CA19-9与CRP的高表达患者与正常水平患者相比,转移患者比例更高(47/61; 54/72; 52/68)(P<0.05),1年、2年、3年生存率均更低(14/61、17/72、20/68;8/61、10/72、12/68; 3/61、4/72、4/68)(P<0.05);血清LDH, CA19-9与CRP联合检测,三者均高表达患者与其他患者相比,转移患者比例更高(36/43)(P<0.05),1年、2年、3年生存率均更低(6/43; 4/43; 1/43)(P<0.05),较各血清指标单独检测差异更为显著;血清LDH、CAl9-9、CRP水平均与胰腺癌患者的预后相关(P<0.05),而三者联合检测与胰腺癌患者预后的相关性更高(HR=2.368,P=0.008)。结论  血清LDH、CA19-9、CRP等指标的高表达均提示胰腺癌患者的预后不良,联合检测则可更好的预测胰腺癌患者的预后情况。

关键词： 乳酸脱氢酶; 癌抗原19-9; C反应蛋白; 胰腺癌; 预后

Abstract：

Objective  The correlation between serum LDH, CA19-9 and CRP combined with prognosis of pancreatic cancer was analyzed. Methods  Retrospective analysis of clinical and pathological data of 130 patients with pancreatic cancer who were treated in our hospital from April 2012 to April 2014. The serum levels of lactate dehydrogenase (LDH), cancer antigen 19-9 (CA19-9) and C-reactive protein (CRP) were measured before treatment. To study the relationship between serum LDH, CA19-9 and CRP combined with clinicopathological factors and prognosis in patients with pancreatic cancer. Results  The proportion of patients with stage III and IV TNM stage was higher in patients with elevated serum LDH, CA19-9 and CRP (53/61; 67/72; 61/68)(P<0.05), and the proportion of patients with lymph node involvement was higher (48/61; 50/72; 46/68)(P<0.05). Compared with patients with normal levels, serum LDH, CA19-9 and CRP patients had higher proportion of metastatic patients (47/61; 54/72; 52/68)(P<0.05), and the survival rates were lower in one, two and three years (14/61, 17/72, 20/68; 8/61, 10/72, 12/68; 3/61, 4/72, 4/68)(P<0.05). Compared with other patients, the patients with high serum LDH, CA19-9 and CRP had a higher proportion of metastatic patients(36/43) (P<0.05), and the survival rates were lower in one, two and three years (6/43; 4/43; 1/43)(P<0.05). Separate detection of each serum index is more significant; Serum LDH, CAl9-9, and CRP levels were associated with prognosis in patients with pancreatic cancer (P<0.05), and the combined detection of the three groups was associated with higher prognosis in patients with pancreatic cancer (HR=2.368, P=0.008). Conclusion  High expression of serum LDH, CA19-9, and CRP all indicate poor prognosis in patients with pancreatic cancer, and combined detection can better predict the prognosis of patients with pancreatic cancer.

Key Words:  Lactate dehydrogenase; Cancer antigen 19-9; C-reactive protein; Pancreatic cancer; Prognosis