Objective Serum abnormal prothrombin (PIVKA-Ⅱ) level was detected in pancreatic cancer patients and its clinical value in diagnosing and treating pancreatic cancer was explored.Methods A total of 112 pancreatic cancer patients,28 benign pancreatic diseases patients and 79 healthy controls were collected from Cancer Hospital of Hubei Province.Serum PIVKA-Ⅱ level was determined by chemiluminescent immunoassay (CLIA).CEA and CA19-9 level was detected by electrochemiluminescence immunoassay (ECLIA).Receiver operation characteristic (ROC) curve was drawn and the cut-off value was set.The sensitivity,specificity and accuracy were calculated.Results PIVKA-Ⅱ level in 112 pancreatic cancer patients was 39.0 (22.61,137.67)U/L[median (quartile range)],which was significantly higher than that in 30 patients with benign pancreatic disease [23.0 (17.32,29.67) U/L] and 79 healthy controls [21.21 (17.9,25.12) U/L].The differences were statistically significant (P＜0.01).However,there was no significant difference between benign pancreatic disease patients and healthy controls.ROC analysis showed that area under curve(AUC) for PIVKA-Ⅱ,CEA and CA19-9 was 0.793,0.707 and 0.849.The cut-off value for discriminating pancreatic cancer was established at 32.4,4.7 and 27.0 U/L for PIVKA-Ⅱ,CEA and CA19-9.The sensitivity was 61.6％,38.0％ and 66.1％,and the specificity was 86.3％,96.3％ and 89.9％,and the accuracy was 71.7％,62.3％ and 75.0％,respectively.The sensitivity,specificity and accuracy of PIVKA-Ⅱ combined with CEA and CA19-9 was 90.2％,76.0％ and 84.3％.The sensitivity was obviously higher,while the specificity was lower.Serum PIVKA-Ⅱ level was associated with advanced tumor stage.There were 20 patients who were followed up.PIVKA-Ⅱ level in 15 cases were decreased after surgery or interventional therapy (50.6 U/L vs 110.5 U/L,P ＜0.001),which was increased in 4 of the five cases who received palliative care to a various degree.Conclusions PIVKA-Ⅱ detection could benefit the diagnosis and prognosis monitoring of pancreatic cancer.

The incidences of colorectal and lung cancer are both increased in China while the treatment effect is far from satisfactory. As the rapid progress of epigenetic studies, DNA methylation has a series of promising research results in the pathogenesis, early diagnosis and treatment of tumor. A comprehensive understanding of its development status and existing problems is of great significance for the future research and the implementation of precision medicine. Herein, the aim is to outline the progress of DNA methylation in Colorectal and lung cancer and make a prospect for the future research.