Evaluation of the diagnostic value of YiDiXie™-SS, YiDiXie™-HS and YiDiXie™-D in pancreatic cancer

Xutai Li, Pengwu Zhang, Hui Zhang, Chen Sun, Yutong Wu, Huimei Zhou, Zhenjian Ge, Shengjie Lin, Yingqi Li, Wenkang Chen, Wuping Wang, Siwei Chen, Wei Li, Fei Feng, Zewei Lin, Ling Ji, Yongqing Lai
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Abstract

BACKGROUND: Pancreatic cancer is a serious threat to human health. Ultrasound is widely used in screening or preliminary diagnosis of pancreatic cancer, and enhanced CT is widely used in the diagnosis of pancreatic cancer. However, false-positive results of ultrasound and enhanced CT will bring unnecessary mental pain, expensive examination costs, physical injuries, and even adverse consequences such as organ removal and loss of function; while false-negative results of enhanced CT bring delayed treatment, and patients will thus have to bear the adverse consequences of poor prognosis, high treatment costs, poor quality of life, and short survival period. There is an urgent need to find convenient, cost-effective and non-invasive diagnostic methods to reduce the false-positive rate of ultrasound and the false-negative and false-positive rates of enhanced CT in pancreatic tumors. The aim of this study was to evaluate the diagnostic value of YiDiXie™-SS, YiDiXie™-HS and YiDiXie™-D in pancreatic cancer. MATERIALS AND METHODS: 62 subjects (malignant group, n=37; benign group, n=25) were finally included in this study. Remaining serum samples from the subjects were collected and tested by applying the YiDiXie™ all-cancer detection kit to evaluate the sensitivity and specificity of YiDiXie™-SS, YiDiXie™-HS and YiDiXie™-D, respectively. RESULTS: The sensitivity of YiDiXie™-SS in pancreatic ultrasound-positive patients was 100% (95% CI: 90.6% - 100%) and the specificity was 60.0% (95% CI: 55.4% - 69.7%). Compared with enhanced CT alone, sequential use of YiDiXie™-SS and enhanced CT resulted in comparable sensitivity, but the false-positive rate decreased from 24.0% (95% CI: 11.5% - 43.4%) to 8.0% (95% CI: 1.4% - 25.0%). This means that the application of YiDiXie™-SS reduces the false-positive rate of ultrasound by 60.0% (95% CI: 55.4% - 69.7%) and reduces the false-positive rate of enhanced CT by 66.7% with essentially no increase in the leakage of malignant tumors.YiDiXie™-HS had a sensitivity of 85.7% (95% CI: 48.7% - 99.3%) and a specificity of 84.2% (95% CI: 62.4% - 92.5%) in enhanced CT-negative patients. This means that YiDiXie™-HS reduces the false-negative enhancement CT rate by 84.2% (95% CI: 62.4% - 92.5%). YiDiXie™-D has a sensitivity of 33.3% (95% CI: 19.2% - 51.2%) and a specificity of 100% (95% CI: 61.0% - 100%) in patients with positive enhancement CT. This means that YiDiXie™-D reduces the false positive rate of enhanced CT by 100% (95% CI: 61.0% - 100%). CONCLUSION: YiDiXie™-SS significantly reduces the false-positive rate of ultrasound and enhanced CT in ultrasound-positive pancreatic patients with essentially no increase in delayed treatment of malignant tumors. YiDiXie™-HS significantly reduces the false-negative rate of enhanced CT in patients with pancreatic tumors. YiDiXie™-D significantly reduces the false-positive rate of enhanced CT in patients with pancreatic tumors. The YiDiXie™ test has significant diagnostic value in pancreatic cancer, and is expected to solve the problem of "excessive false-positive rate of ultrasound", "enhanced CT" and "false-negative rate of pancreatic tumors" in pancreatic tumors. Clinical Research Registration Number:ChiCTR2200066840. Keywords: Pancreatic cancer, Ultrasound, Enhanced CT, False-positive, False-negative, YiDiXie™-SS, YiDiXie™-HS, YiDiXie™-D
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评估 YiDiXie™-SS、YiDiXie™-HS 和 YiDiXie™-D 对胰腺癌的诊断价值
背景:胰腺癌严重威胁人类健康。超声波被广泛应用于胰腺癌的筛查或初步诊断,增强 CT 被广泛应用于胰腺癌的诊断。然而,超声和增强 CT 的假阳性结果会给患者带来不必要的精神痛苦、昂贵的检查费用、身体伤害,甚至切除器官、丧失功能等不良后果;而增强 CT 的假阴性结果则会延误治疗,使患者不得不承担预后差、治疗费用高、生活质量低、生存期短等不良后果。因此,亟需找到便捷、经济、无创的诊断方法,以降低胰腺肿瘤超声的假阳性率和增强 CT 的假阴性率和假阳性率。本研究旨在评估 YiDiXie™-SS、YiDiXie™-HS 和 YiDiXie™-D 对胰腺癌的诊断价值。收集受试者的剩余血清样本,并使用 YiDiXie™ 全癌检测试剂盒分别检测 YiDiXie™-SS、YiDiXie™-HS 和 YiDiXie™-D 的灵敏度和特异性。结果:YiDiXie™-SS 对胰腺超声阳性患者的敏感性为 100%(95% CI:90.6% - 100%),特异性为 60.0%(95% CI:55.4% - 69.7%)。与单独使用增强 CT 相比,连续使用 YiDiXie™-SS 和增强 CT 的灵敏度相当,但假阳性率从 24.0% (95% CI: 11.5% - 43.4%) 下降到 8.0% (95% CI: 1.4% - 25.0%)。在增强 CT 阴性患者中,YiDiXie™-HS 的灵敏度为 85.7%(95% CI:48.7% - 99.3%),特异度为 84.2%(95% CI:62.4% - 92.5%)。这意味着 YiDiXie™-HS 可将增强 CT 假阴性率降低 84.2% (95% CI: 62.4% - 92.5%)。YiDiXie™-D 对增强 CT 阳性患者的敏感性为 33.3%(95% CI:19.2% - 51.2%),特异性为 100%(95% CI:61.0% - 100%)。这意味着 YiDiXie™-D 可将增强 CT 的假阳性率降低 100%(95% CI:61.0% - 100%)。结论:YiDiXie™-SS 能显著降低超声阳性胰腺患者超声和增强 CT 的假阳性率,而且基本上不会增加恶性肿瘤的延迟治疗。YiDiXie™-HS 可显著降低胰腺肿瘤患者增强 CT 的假阴性率。YiDiXie™-D 可明显降低胰腺肿瘤患者增强 CT 的假阳性率。YiDiXie™检验对胰腺癌具有重要的诊断价值,有望解决胰腺肿瘤 "超声假阳性率过高"、"增强CT假阳性率过高 "和 "胰腺肿瘤假阴性率过高 "的问题。临床研究注册号:ChiCTR2200066840:胰腺癌 超声 增强CT 假阳性 假阴性 YiDiXie™-SS YiDiXie™-HS YiDiXie™-D
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