CA19-9、FIB、PIVKA-II三者联合检测在胰腺癌微血管侵犯诊断中的应用价值

时 浩蔓, 李衍 飞*
青海大学附属医院肝胆胰外科;青海省包虫病研究重点实验室

摘要


胰腺癌是一种具有高度侵袭性的恶性肿瘤，其早期诊断困难及微血管侵犯（MVI）是影响患者生存率的重要因素。近年来，CA19-9、纤维蛋白原（FIB）及异常凝血酶原II（PIVKA-II）等肿瘤标志物在胰腺癌的早期诊断及预后评估中备受关注。CA19-9虽被广泛用于胰腺癌的早期筛查和诊断，但其特异性不足且易受非肿瘤性因素干扰；纤维蛋白原（FIB）作为炎症与肿瘤微环境的关键介质，通过调控血管生成和血栓形成与微血管侵犯密切相关，成为评估胰腺癌侵袭性的潜在指标；而PIVKA-II作为新型标志物，已在部分研究中显示出与胰腺癌患者预后的相关性。目前，关于CA19-9、FIB及PIVKA-II在胰腺癌微血管侵犯中的研究主要集中在单个指标上，缺乏对这些指标的综合总结分析。本综述系统总结上述生物标志物在胰腺癌微血管侵犯诊断、预测中的进展，探讨其临床价值及潜在生物学机制，为后期优化胰腺癌精准诊疗策略提供理论依据。

关键词


CA19-9；纤维蛋白原（FIB）；异常凝血酶原II（PIVKA-II）；胰腺癌；微血管侵犯；联合检测；诊断

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参考


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