摘要
目的探讨CA19-9、CA242、CEA和CA125四种肿瘤标志物单独检测或联合检测在胰腺癌诊断和预后中的价值。方法测定并分析我院2007年1月至2009年12月期间收治的63例胰腺癌患者、33例胆管癌和27例胰腺良性疾病患者血清中CA19-9、CA242、CEA和CA125水平,并对术后胰腺癌患者进行随访。结果胰腺癌患者血清中CA19-9、CA242、CEA和CA125水平明显高于胰腺良性疾病患者和胆管癌患者（P〈0.05）。单项检测中血清CA19-9的敏感性最高,达79.4%（50/63）,但其特异性（61.7%）低于CA242（83.3%）和CEA（80.0%）。联合检测CA19-9＋CA242＋CEA的特异性最高,达93.3%（56/60）。当肿瘤位于胰腺体/尾部时CA19-9水平显著高于其在胰腺头部或全胰腺时（P〈0.05）。胰腺癌Ⅳ期患者的CA19-9和CA242水平显著高于Ⅰ或Ⅱ/Ⅲ期患者（P〈0.05）。本组失访15例,48例获得随访,随访时间平均6个月（2~12个月）。胰腺癌患者术后0.5及3个月血清中CA242、CA19-9较术前明显降低（P〈0.05）。结论单项检测CA19-9可以提高胰腺癌诊断的敏感性,联合检测CA19-9＋CA242＋CEA可以提高胰腺癌诊断的特异性,CA19-9和CA242对胰腺癌的治疗效果及预后判断更具有价值。
Objective To explore the values of CA19-9,CA242,CEA,and CA125 single or combined detection on clinical diagnosis and prognosis for patients with pancreatic cancer.Methods Serum tumor markers CA19-9,CA242,CEA,and CA125 of 63 patients with pancreatic cancer,33 patients with cancer of bile duct,and 27 patients with benign pancreatic disease were detected,and those patients were followed up after operation.Results The levels of CA19-9,CA242,CEA,and CA125 in patients with pancreatic cancer were significantly higher than those in patients with benign pancreatic disease and cancer of bile duct（P0.05）.The sensitivity of CA19-9 alone was the highest in the four tumor markers for the patients with pancreatic cancer（79.4%（50/63））,but the specificity（61.9%） was lower than that of CA242（83.3%） and CEA（80.0%）.The specificity of combined detection of CA19-9＋CA242＋CEA was the highest（93.3%（56/60））.The level of CA19-9 in carcinoma of body/tail of pancreas was significantly higher than that of carcinoma of pancreas head or whole pancreas（P0.05）.The serum levels of CA19-9 and CA242 in patients with stage Ⅳ were significantly higher than those in stage Ⅰ or Ⅱ/Ⅲ（P0.05）.Fifteen patients were lost to follow up,48 patients were followed up 2-12 months with an average 6 months.The levels of CA242 and CA19-9 in patients with pancreatic cancer on 0.5 month and 3 months after operation were lower than those before operation（P0.05）.Conclusions Single detection of CA19-9 can improve the diagnostic sensitivity,and combined detection of tumor markers CA19-9＋CA242＋CEA can improve the diagnostic specificity.CA19-9 or CA242 is a valuable marker for evaluating treatment effects and estimating prognosis.
出处
《中国普外基础与临床杂志》
CAS
2011年第3期300-304,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
胰腺癌
肿瘤标志物
诊断
预后
Pancreatic cancer
Tumor marker
Diagnosis
Prognosis
作者简介
【作者简介】李宁（1982年-），男，山东省菏泽人，在读硕士，医师，主要研究方向为肝胆外科，E—mail：ln528@sina．com。
【通讯作者】沈世强，Email：swsw2218@hotmail．com
