The neutrophil-to-lymphocyte ratio, CA19-9 and CEA in the diagnosis of pancreatic cancer / 中华肝胆外科杂志

ABSTRACT

Objective To study the neutrophil-lymphocyte ratio (NLR),CA19-9 and CEA in the diagnosis of pancreatic cancer (PC).Methods From January 2013 to June 2016,the data of 723 consecutive patients with pancreatic diseases were reviewed.Of these 723 patients,632 patients had PC (stage Ⅰ,Ⅱ 324 patients;stage Ⅲ,Ⅳ 289 patients),66 patients had pancreatic cystic tumors,and 26 patients had tumor-forming pancreatitis.The Receiver Operating Curve (ROC) and the logistic regression model were used to assess the blood biomarkers in predicting PC.Results Using the ROC,CA19-9 CEA,NLR,PLR,ALP,GGT,LDH,GLU and MONO# were useful in diagnosing malignant pancreatic diseases.Logistic regression analysis showed that CA19-9 (95％ CI12.928 ～ 103.330;P ＜ 0.05),CEA (95％ CI1.041 ～3.472,P＜0.05) and NLR (95％ CI1.020～ 3.525,P =0.043) were independent variables in predicting PC.The concentrations of CA19-9,CEA,and NLR had the highest values in predicting PC.When CA19-9 was ＜37 kU/L,the concentrations of NLR and CEA had a high sensitivity and specificity (AUC =0.746,95％CI0.675～0.816,P＜0.05) of 69.2％ and 73.6％,respectively.Conclusions The concentrations of CA19-9,CEA,and NLR had the highest prediction value for PC.When the level of CA19-9 was ＜37 kU/L,the combined use of NLR and CEA significantly improved the diagnostic specificity.