摘要目的:研究癌抗原199（CA199）联合血清异常凝血酶原在胰腺癌早期诊断中的临床价值。方法:以2017年6月至2018年12月本院收治的胰腺癌患者40例为胰腺癌组，另取同期收治的胰腺良性病变患者40例为胰腺良性病变组，再选择同期于本院进行体检的健康者40例为正常对照组。分别采用酶联免疫吸附法检测3组人员血清CA199以及异常凝血酶原水平，同时计算CA199、异常凝血酶原以及两项联合检测胰腺癌的灵敏度、特异性、准确度，并与病理结果进行对比。结果:胰腺癌组患者血清CA199以及异常凝血酶原水平均分别明显高于胰腺良性病变组，而胰腺良性病变组又明显高于正常对照组。以病理诊断为标准，联合组检测结果中真阳性人数占比为87.50%，明显高于CA199以及异常凝血酶原检测（分别为67.50%、65.00%）；联合组诊断灵敏度、准确度分别为87.50%、86.25%，均明显高于CA199以及异常凝血酶原检测。术后6个月胰腺癌患者血清CA199以及异常凝血酶原水平均明显低于手术前。以上指标比较，差异均有统计学意义（均 P<0.05）。 结论:CA199联合血清异常凝血酶原应用于胰腺癌早期诊断中具有较高的价值，可有效提高临床诊断的灵敏度以及准确度，并可为评估预后提供参考。

abstractsObjective:To study the clinical value of cancer antigen 199 (CA199) combined with abnormal serum prothrombin in the early diagnosis of pancreatic cancer.Methods:40 cases of pancreatic cancer treated in our hospital from June 2017 to December 2018 were recorded as pancreatic cancer group. In addition, 40 patients with benign pancreatic lesions were recorded as benign pancreatic lesions group. During the same period, 40 healthy subjects were selected as the normal control group. The serum CA199 and abnormal serum prothrombin levels were detected by enzyme linked immunosorbent assay (ELISA) in the three groups. The sensitivity, specificity, and accuracy of CA199, abnormal prothrombin, and their combination in the detection of pancreatic cancer were calculated, which were compared with the pathological results.Results:The levels of serum CA199 and abnormal prothrombin in the pancreatic cancer group were significantly higher than those in the benign pancreatic lesions group ( P<0.05), those in the benign pancreatic lesions group were significantly higher than those in the normal control group ( P<0.05). With the pathological diagnosis as the gold standard, the proportion of true positive in the test results of the combined detection was 87.50%, which was significantly higher than 67.50% of CA199 detection and 65.00% of abnormal prothrombin detection ( P<0.05); the diagnostic sensitivity and accuracy of the combined detection were 87.50%, 86.25%, which were significantly higher than those of CA199 and abnormal prothrombin detection ( P<0.05). The levels of serum CA199 and abnormal prothrombin in the patients with pancreatic cancer at 6 months after surgery were significantly lower than those before the surgery ( P<0.05). Conclusion:CA199 combined with abnormal serum prothrombin has high value in the early diagnosis of pancreatic cancer, which can effectively improve the sensitivity and accuracy of clinical diagnosis, and can provide reference for evaluating the prognosis.