摘要
目的探讨血清CEA、CA19-9和CA242单独和联合检测在胰腺癌诊断和预后中的作用。方法回顾性分析了105例胰腺癌患者,70例非胰腺外分泌恶性肿瘤以及30例胰腺良性疾病患者术前血清CEA、CA19-9和CA242水平。结果CA19-9对胰腺癌诊断的敏感性最高(80%),但其特异性明显低于CEA和CA242(P<0.01)。CEA和CA242联合检测可将胰腺癌诊断的特异性提高到92%。CEA、CA19-9和CA242水平不受肿瘤大小以及可切除性的影响(P>0.05),但在Ⅳ期胰腺癌患者中明显提高(P<0.05)。血清CEA和CA19-9的水平与患者的生存时间无明显的相关性,而血清CA242阳性的胰腺癌患者的生存时间较阴性患者的生存时间明显缩短(P<0.05)。结论CA19-9对胰腺癌的诊断阳性率优于CEA和CA242。联合检测CEA和CA242明显提高诊断的特异性。3者水平明显升高提示病情进入晚期,血清CA242明显升高提示生存期短,预后差。
Objective Serum tumor markers carcinoembryonic antigen （CEA）, carbohydrate antigen 19 -9 （CA19- 9）, and CA242 were investigated to evaluate the values of single and combined test in the diagnosis and prognosis of pancreatic cancer. Methods Preoperative serum CEA, CA19-9, and CA242 were measured in 105 pancreatic canc- er, 70 non-pancreatic malignance, and 30 benign pancreatic diseases. Results The sensitivity of CA19-9 alone was the highest in pancreatic cancer patients （ 80% ）, but the specificity was significantly lower than that of CEA and CA242 （P 〈0.01）. The combination of CEA and CA242 could increase the specificity to 92%. CEA, CA19-9, and CA242 were not affected by the tumor size and resectability （P 〉 0. 05）, whereas serum CEA, CA19-9, and CA242 in stage 1V patients were raised sharply （P 〈 0.05 ）. In serum CA242 positive patients, the survival times were remarkably shorter than patients with negative result （P 〈 0.01 ）. The serum levels of CEA and CA19-9 were not correlated well with the survival times （ P 〉 0.05 ）, Conclusion The diagnostic rate of CA19-9 in pancreatic cancer is better than that of CEA and CA242. Combined detection of CEA and CA242 can improve the diagnostic specificity obviously. High levels of serum markers are associated with advanced stage of the disease. CA242 is an important prognostic factor for pancreatic cancer.
出处
《中国医刊》
CAS
2007年第6期25-28,共4页
Chinese Journal of Medicine
基金
国家自然科学基金资助项目(NO.30500582)
