Analyze Diagnosis Value And Resectability Of Preopreative Detection Of Multiple Serum Tumor Markers And Platelet Distribution Width On Pancreatic Cancer

Objectives:To investigate the diagnosis value and analyze resectability of preoperative serum CA199,CA125,CA50,CEA single and combine detection and PDW of pancreatic cancer.Methods:Retrospective analysis the data of patients with pancreatic cancer who were treated at the Second Affiliated Hospital of Kunming Medical University from September 2016 to September 2018.According to the Comprehensive guidelines for the diagnosis and treatment of pancreatic cancer(2018 version),100 patients which are confirmed pancreatic duct adenocarcinoma by pathologically were screened.100 patients were divided into:1.the resectable pancreatic cancer group(33 patients);2.the borderline resectable pancreatic cancer group(33 patients);3.the unresectable pancreatic cancer group(34 patients).Another 33 patients with benign pancreatic lesions(pancreatic pseudocyst)were selected as the control group.Statistical their age,gender,comorbidities,confirmed that there was no significant difference(P>0.05).By detecting preoperative serum CA199,CA125,CA50,CEA,above four combined detection and PDW levels,comparing the difference in the expression of markers in each group.ROC curves were drawn and the AUC values were compared to evaluate the diagnostic value and resectability of each tumor marker for pancreatic cancer.Results:1.The levels of CA199,CA125,CA50 and CEA in the resectable pancreatic cancer group,the borderline resectable pancreatic cancer group and the unresectable pancreatic cancer group were significantly higher than those in the benign pancreatic lesion group(P<0.01).There was a correlation between tumor markers and resectability of pancreatic cancer.As the resectability of patients with pancreatic cancer decreased,the levels of CA199,CA125,CA50 and CEA increased gradually,and the difference was significant(P<0.05).However,there was no significant difference in PDW levels between the four groups(P>0.05).2.The results of single test of serum CA199,CA125,CA50 and CEA levels in three groups of preoperative pancreatic cancer patients suggest that the sensitivity of CA199 single test is the highest among the four serum tumor markers,and the highest specificity is CA50 and CEA.With the decrease of resectability,the sensitivity and specificity of CA199,CA125,CA50 and CEA for their diagnosis are gradually increasing.The sensitivity and specificity of the combined detection of four tumor markers in the diagnosis and resectability of patients with pancreatic cancer were higher than any single test,and>95%(P<0.01).3.The results of ROC description of serum CA199,CA125,CA50,and CEA levels in the three groups of pancreatic cancer patients before surgery indicated that CA199 had the highest AUC value,than were CEA and CA50,and CA125 was low in single test.The AUC values of the four joint tests were higher than the single test or equal to the CA199 single test(P<0.01).Conclusions:1.The preoperative levels of serum CA199,CA125,CA50 and CEA in the pancreatic cancer group were significantly higher than those in the benign pancreatic lesions.Each tumor marker has diagnostic value for pancreatic cancer.There is a correlation between the four serum tumor markers and the resectability of pancreatic cancer.As the resectability is gradually reduced,the elevated levels of the four tumor markers gradually increase.2.The preoperative combined detection of serum CA 199,CA 125,CA50 and CEA in patients with pancreatic cancer was more accurate than the single detection of each tumor marker in the diagnosis value and resectability of pancreatic cancer.3.There was no correlation between the preoperative detection of PDW levels in pancreatic cancer patients with the diagnosis value and resectability of pancreatic cancer.