摘要
[目的]研究分析超声内镜(EUS)联合血清肿瘤标志物CA199、CA242、CEA及腹部增强CT检查对胰腺癌高危人群的早期筛查率。[方法]回顾性分析入院行血清CA199、CA242、CEA检测,腹部增强CT检查及EUS检查[EUS检查异常者行EUS引导下细针抽吸穿刺术(EUS-FNA)进行细胞学及组织形态学活检]胰腺癌高危人群的结果,对比3种检查手段对胰腺癌的诊断筛查率。[结果]136例中行EUS-FNA患者有90例,反复多次穿刺11例,最终确诊胰腺癌74例,漏诊或未证实4例,诊断率为94.9%;其中EUS对胰腺癌的筛查率为54.4%,诊断敏感性、特异性高于单项检查,且有症状组(96.6%、83.3%)高于无症状组(70.0%、85.5%);上腹增强CT确诊病例70例,漏诊8例,诊断率为89.7%;3种血清学标志物均阳性患者70例,诊断率89.7%。3种检查方法联合检查对胰腺癌的诊断率高达96.2%。[结论]EUS联合多种肿瘤标记物及影像学检查能提高胰腺癌高危人群早期筛查诊断率。
[Objective] To determine the clinical value of EUS in combination with detection of CA199 and CEA and enhanced abdomen CT or MR scan for early diagnosis of pancreatic cancer.[Methods]The data of the patients with high risk of pancrease cancer. including the increased plasma levels of CA199 ,CA242 and CEA measured by ELI SA, abnormal image found by enhanced abdomen CT scan or EUS .were collected from January of 2015 to April of 2018, For the cases with abnormal EUS image,EUS-guided fine needle aspiration and biopsy( EUS-FNA) were performed to confirm the pancreases cancer. The correct diagnose rate of pancreatic cancer with the three methods were compare. Results]In the 136 patients,90 cases were detected by EUS-FNA, in which 11 cases accepted repeated aspiration biopsy, Finally. 74 cases were confirmed pancreatic cancer, 4 cases were misdiagnosed or uncertain diagnosed. The diagnostic rate was 94. 9%. The diagnostic sensitivity and specificity of the combinational group was higher than separate inspection group, and the symptomatic group( 96. 6 %,83. 3 %) was higher than asymptomatic group( 70 .0%985.5 %). Enhancement abdomen CT confirmed 70 cases and of misdiagnosed 8 cases? The diagnostic rate of enhancement CT was 89.7 %. 70 cases showed positive results of all three serological markers. The diagnostic rate of serological markers was 89. 7 %. The diagnostic rate of the three inspection methods was 96. 2%.[Conclution]EUS combined with enhanced abdomen CT scan and serological markers of CA199, CA242 ,CEA can increase the diagnose rate of early pancreatic cancer.
作者
高山
丁祥武
王玮
田爱霞
王道蓉
童旭东
李峥
王晓凡
GAO Shan;DING Xiang-wu;WANG Wei;TIAN Ai-xia;WANG Dao-rong;TONG Xudong;LI Zheng;WANG Xiao-fan(Department of Gastroenterology,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Science.441021 Xiangyang.China;Department of Gastroenterology,the Affiliated Puai Hospital of Tongji Medical College,Huazhong University of Science and Technology,430034 Wuhan.China)
出处
《临床消化病杂志》
2019年第2期108-112,共5页
Chinese Journal of Clinical Gastroenterology
基金
襄阳市科技局资助项目(No:2012-40-5).
