To investigate the expression of serum Glypican-1 (GPC-1) in pancreatic cancer and the diagnostic value of combined CA19-9 and CEA in pancreatic cancer.

Sixty patients with pancreatic cancer were recruited in Qingdao Municipal Hospital from October 2018 to July 2020, while thirty-one patients with benign pancreatic lesions and fifty healthy controls were selected in the same period. The expression of GPC-1 in serum was detected by ELISA. The levels of serum CA19-9 and CEA were detected by immunochemiluminescence assay, and the expression levels of serum GPC-1, CA19-9and CEA were analyzed and compared. The receiver operating characteristic curve (ROC) was used to evaluate the early diagnostic value of GPC-1, CA19-9, CEA alone and in combination for pancreatic cancer and pancreatic cancer with negative serological markers.

The expression level of serum GPC-1in patients with pancreatic cancer was correlated with vascular invasion, pancreatic duct dilatation, TNM staging, lymph node and distant metastasis (all P<0.05). Serum GPC-1, CA19-9, and CEA were all highly expressed in pancreatic cancer (P<0.05). The diagnostic value of GPC-1 was higher than CA19-9 and CEA in the diagnosis of pancreatic cancer with a single index; when distinguishing pancreatic cancer from healthy control group and benign pancreatic lesions, GPC-1+CA19-9, GPC-1+CEA or their combination was significantly higher than any single index, with the highest diagnostic value (AUC was 0.916 and 0.870, respectively). The expression of GPC-1 in patients with single or double negative of CA19-9 and CEA was higher than that in healthy controls and patients with benign pancreatic lesions, the difference was statistically significant (P<0.05). When GPC-1 was used to distinguish the patients with single negative or double negative pancreatic cancer of CA19-9 and CEA, and healthy control and benign pancreatic lesions, the AUC was 0.683-0.825, the sensitivity was 71.4%-87.5%, the specificity was 65.0%-82.9%, the accuracy was 73.9%-84.7%.

The high expression of serum GPC-1 in pancreatic cancer is positively correlated with vascular invasion, pancreatic duct dilatation, TNM staging, lymph nodes and distant metastasis. The combined detection of serum GPC-1, CA19-9 and CEA can improve the diagnostic value of pancreatic cancer and make up for the deficiency of traditional single serological marker detection. It is a convenient and sensitive auxiliary screening method for pancreatic cancer.