摘要
目的评价肿瘤标志物CA19-9、CA242、CEA单独或联合检测在肝胆管结石合并胆管癌诊断与预后评估中的作用。方法对100例确诊的肝胆管结石合并胆管癌（异常胆管组）患者，手术前检测血清CA19-9、CA242、CEA值，并检测70例肝胆管结石合并胆管炎患者和30例肝血管瘤（正常胆管组）患者的血清CA19-9、CA242、CEA水平。结果单独应用于异常胆管组诊断时，CA199的灵敏度最高，但是其特异性显著低于CA242和CEA（P〈0．01）。三项肿瘤标志物中，两项以上高于正常值的患者其生存期显著低于仅有一项高于正常值或三项皆正常的患者（P〈0．05）。结论CA19-9在异常胆管组诊断率方面优于CEA和CA242，联合检测可以提高诊断的特异性；肿瘤标志物高水平与肝胆管结石合并胆管癌进展期相关；三项肿瘤标志物中两项或三项高于正常值的患者其生存期较短。
Objective To study the values of serum CA19 9, CA242, CEA, alone or in combi nation in the diagnosis and prognosis of combined hepatobiliary calculus and cholangiocarcinoma （HCWC）. Method Serum CA19-9, CA242, CEA in 100 patients with HCWC, 70 patients with hepatobiliary calculus combined with cholangitis and 30 patients with hepatic hemangioma （normal bile duct group） were preoperatively studied. Results When the serum levels of CA19-9, CA242, CEA were separately used in the diagnosis of HCWC, the sensitivity of CA19-9 was highest, but its speci ficity was significantly lower than that of CA242 and CEA （P〈0.01）. Patients with all the three tumor markers raised had significantly lower survival than those of patients with only one or two raised markers （P〈0.05）. Conclusions The diagnostic rate for CA19-9 in HCWC was better than that of CEA and CA242. A joint detection improved the diagnostic specificity. Raised tumor markers were associated with progression of HCWC. Survival was worse in patients with 3 raised markers than those with 2 or 1 raised markers.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2013年第9期665-668,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
胆结石
胆管肿瘤
抗原
肿瘤
诊断
预后
Cholelithiasis
Bile duct neoplasms
Antigens, neoplasm
Diagnosis
Prognosis
作者简介
通信作者：彭德珍，电子信箱：4438790@qq．com
