CEA、CA19-9、CA50水平与胰腺癌分期和肿瘤大小的关系

目的 探讨血清肿瘤标志物CEA、CA19-9、CA50水平与胰腺癌分期和肿瘤大小的关系.方法 分别测定35例胰腺癌和36例慢性胰腺炎患者血清CEA、CA19-9与CA50水平.外科手术和(或)病理学判定TNM分期和肿瘤大小,分析两者之间的关系.结果 血清CEA、CA19-9、CA50对胰腺癌诊断的敏感性分别为42%、82%、74%.特异性分别为75%、83%、77%.Ⅲ + Ⅳ期的CA19-9和CA50水平明显高于Ⅰ + Ⅱ期患者(P ＜ 0.05),CEA超过正常值者仅见于Ⅲ期以上胰腺癌患者.TS3 + TS4组的CEA、CA19-9、CA50水平比TS1 + TS2组明显增高(P ＜ 0.05).结论 胰腺癌血清CEA、CA19-9、CA50水平与胰腺癌分期和肿瘤大小有一定相关性,对手术前判断胰腺癌的可切除性有一定的参考价值.     

43例胰腺癌患者血清CA19-9、CA125、CEA水平检测及分析

目的 探讨血清肿瘤标志物CA19-9、CA125及癌胚抗原（CEA）联合检测对胰腺癌诊断及疗效监测的价值.方法 采用全自动电化学发光分析仪测定43例胰腺癌患者（胰腺癌组）及40例健康查体者（对照组）血清CA19-9、CA125及CEA水平,其中胰腺癌组手术前及术后1个月各测定1次;根据试剂厂家提供的参考值计算三种标志物诊断胰腺癌的敏感性、特异性及准确性.结果 胰腺癌组手术前后血清CA19-9、CA125及CEA水平均显著高于对照组（P＜0.01）,尤以术前为著（P＜0.05）;三种肿瘤标志物术后阳性率均显著低于术前（P＜0.05）,联合检测上述三种肿瘤标志物诊断胰腺癌的敏感性、特异性及准确性均显著高于单一标志物检测（P＜0.05）. 结论联合检测血清CA19-9、CA125、CEA水平对胰腺癌的辅助诊断、疗效判定、病情监测等均有重要价值.     

联合检测血清TK1、CA19-9对胰腺癌和胰腺炎鉴别诊断的价值

目的 探讨联合检测血清胸苷激酶1（TK1）、糖类抗原19-9（CA19-9）对胰腺癌和胰腺炎鉴别诊断的价值.方法 选择胰腺癌患者37例（胰腺癌组）、胰腺炎患者40例（胰腺炎组）及健康体检者50例（对照组）,采用化学增强发光印迹法检测其血清TK1,直接化学发光法检测血清CA19-9.结果 胰腺癌组、胰腺炎组血清CA19-9水平明显高于对照组（P均＜0.05）,但胰腺癌组与胰腺炎组比较差异无统计学意义.胰腺癌组血清TK1水平明显高于胰腺炎组、对照组（P均＜0.05）,而胰腺炎组与对照组比较差异无统计学意义.两者联合检测能明显提高诊断胰腺癌的敏感性（92.7％）.结论 联合检测血清CA19-9、TK1有助于胰腺炎和胰腺癌的鉴别诊断.     

CEA、CA19—9、CA50水平与胰腺癌分期和肿瘤大小的关系

目的探讨血清肿瘤标志物CEA、CA19-9、CA50水平与胰腺癌分期和肿瘤大小的关系。方法分别测定35例胰腺癌和36例慢性胰腺炎患者血清CEA、CA19—9与CA50水平。外科手术和（或）病理学判定TNM分期和肿瘤大小．分析两者之间的关系。结果血清CEA、CA19—9、CA50对胰腺癌诊断的敏感性分别为12％、82％、74%。特异性分别为75%、83％、77％。Ⅲ-Ⅳ期的CA19—9和CA50水平明显高于Ⅰ-Ⅱ期患者（P〈0.05）．CEA超过正常值者仅见于Ⅲ期以上胰腺癌患者。TS3-TS1组的CEA、CA19-9、CA50水平比TS1-TS2组明显增高（P〈0．05）。结论胰腺癌血清CEA、CA19—9、CA50水平与胰腺癌分期和肿瘤大小有一定相关性．对手术前判断胰腺癌的可切除性有一定的参考价值。     

血浆miR-210联合血清肿瘤标志物对胰腺癌的诊断价值

目的:探讨血浆m i R-210联合血清肿瘤标志物糖链抗原199(carbohydrate antigen 199,CA199)、CA242、癌胚抗原(carcino-embryonic antigen,CEA)对胰腺癌的诊断价值.方法:对60例胰腺癌患者、20例慢性胰腺炎患者及10例正常对照组的血标本进行RNA抽提,并进行mi R-210的实时PCR检测,同时对血清肿瘤标志物CA199、CA242、CEA进行检测,分析血浆mi R-210相对表达量与临床特征的关系,评估血浆mi R-210联合血清肿瘤标志物CA199、CA242、CEA对胰腺癌的诊断效能.结果:mi R-2l0在胰腺癌血浆中的相对表达量显著高于慢性胰腺炎组及正常对照组(4.12±4.51 vs 1.49±3.94,-1.73±4.82;均P0.01),胰腺癌患者血浆m i R-21水平与C A199、C A242、C E A、肿瘤最大直径、T N M分期及临床分期无关.经二分类Logistic回归模型分析发现,血浆mi R-210单独在胰腺癌组比正常组、胰腺癌组比慢性胰腺炎组和胰腺癌组比慢性胰腺炎组+正常组中的敏感性、特异性分别为:96.7%、50.0%;95.0%、25.0%;86.7%、40.0%.血浆m i R-210联合肿瘤标志物CA199、CA242、CEA后在以上三组中的敏感性、特异性分别为:96.7%、70.0%;90.0%、85.0%;86.7%、90.0%.结论:血浆m i R-210联合血清肿瘤标志物C A199、C A242、C E A能提高胰腺癌的诊断效能.     

组织多肽特异性抗原和CA19-9在胰腺癌诊断中的意义

选择胰腺癌患者52例作为治疗组,正常献血者22例作为对照组,采用酶联免疫方法检测血清TPS与CA19-9水平.发现TPS诊断胰腺癌的敏感性和特异性分别为100%(52/52)、91%(20/22),CA19-9分别为69%(36/52)、86%(19/22).胰腺癌患者血清TPS及CA19-9高于对照组(P＜0.05).认为TPS对于胰腺癌的早期诊断优于CA19-9,TPS敏感性高于CA19-9.二者合用对临床分期、判断手术能否切除有一定的帮助.     

血清半乳糖凝集素3对胰腺癌的诊断价值

目的 运用时间分解免疫荧光(TRFIA)法检测血清半乳糖凝集素3(Galectin-3,Gal-3)水平,并探讨Gal-3对胰腺癌的诊断价值.方法 采用固相双抗体夹心法建立检测血清Gal-3的TRFIA,探讨最佳实验条件.在最适条件下检测胰腺癌、胰腺良性占位、胰腺炎患者及健康对照者血清Gal-3水平,并联合检测血清CEA及CA19-9水平.结果 TRFIA法检测血清Gal-3的线性为0～100μg/L,批内变异系数(CV)≤6.45％,批间CV≤8.68％,平均回收率为106.6％.胰腺癌患者血清Gal-3水平为4.93(0.85～23.80) μg/L,明显高于胰腺良性占位者的2.83(2.17～4.06) μg/L、胰腺炎患者的2.62(0.55 ～9.76) μg/L和健康者的1.88(0.59 ～ 3.94) μg/L(P值均＜0.05).以3.77 μg/L为界,其诊断胰腺癌的敏感性为75.5％,特异性达90.9％.Gal-3与CEA及CA19-9水平均无相关性(r=0.1321,P=0.3761；r =0.0920,P=0.5384),Gal-3联合CEA或CA19-9检测,对胰腺癌的诊断敏感性可提高到92％.结论 TRFIA法检测血清Gal-3具有较好的敏感性和稳定性；Gal-3有望成为新的胰腺癌标记物.     

血清KL-6水平在胰腺癌诊断与鉴别诊断中的价值

目的 检测胰腺癌患者血清KL-6水平,探讨其临床诊断价值.方法 收集随访资料完整的53例胰腺癌(PC)、68例慢性胰腺炎(CP)、51例高危人群(high risk person,HR)的血清样本,以50例健康体检者作为对照.用ELISA方法检测血清CA50、MUCA、KL-6水平,放免法测定血清CA19-9水平.分析它们诊断胰腺癌的敏感性、特异性及与临床病理参数、患者预后的关系.结果 PC组、CP组、HR组及对照组的血清KL-6水平分别为(753±548)、(135 ±93)、(105±55)及(99±50)U/ml,PC组显著高于其他3组(P<0.01).以>232 U/ml为界,KL-6诊断胰腺癌的敏感性为96%,特异性为94%;以>244 U/ml为界,鉴别诊断PC与CP的敏感性为97%,特异性为91%.KL-6诊断胰腺癌的临床价值高于CA19-9、CA50及MUC4.胰腺癌患者血清KL-6水平与肿瘤的临床病理参数均无相关性.血清KL-6≤300 U/ml患者的平均生存期为(9.3±1.2)个月,较KL-6>300 U/ml患者平均生存期(4.6±0.7)个月显著延长(P=0.006).结论 KL-6可作为诊断胰腺癌的血清学指标,且对胰腺癌和慢性胰腺炎的鉴别诊断有一定意义.     

肿瘤标记物在细胞学阴性的恶性腹水中的诊断价值

目的 探讨肿瘤标志物CEA 、CA199、CA125在细胞学阴性的恶性腹水中的诊断价值.方法 检测189例腹水患者的血清和腹水肿瘤标记物,评估肿瘤标记物在细胞学阴性的恶性腹水中的诊断价值.结果 在预设的临界值,细胞学阴性的恶性腹水患者血清和腹水CEA 、CA19-9阳性率明显高于良性腹水组（P ＜0.05）;CA12-5两组比较,差异无统计学意义（P＞0.05）.血清CEA 、CA19-9诊断敏感性较低;腹水CEA 、CA19-9诊断敏感性明显提高,特异性相当.腹水CEA、CA19-9的ROC曲线下面积分别为0.94、0.88.结论 肿瘤标记物CEA、CA19-9有助于细胞学阴性恶性腹水的鉴别诊断,CA12-5无诊断价值;其中腹水CEA诊断价值较高.     

血浆微小核糖核酸联合检测对胰腺癌的诊断价值

胰腺癌早期发现困难、预后极差,是实体癌中生存率最低的恶性肿瘤,手术切除率仅为10％～15％,在可切除的胰腺癌中早期胰腺癌仅占15％[1].血清糖类抗原(CA)19-9为目前常用的胰腺癌诊断标志物,但在可切除胰腺癌中只有65％的患者有血清CA19-9升高,而且约有40％的慢性胰腺炎有CA19-9升高.因此血清CA19-9并不能很好地鉴别胰腺癌与慢性胰腺炎,CA19-9在胰腺癌诊断中的敏感性为70％～80％[2],而特异性甚至不到50％[3],这就需要发现新的胰腺癌肿瘤标志物.目前的研究结果表明微小核糖核酸(miRNA)参与了肿瘤进展的分子调控,并在胰腺癌组织中显著高表达,而且与胰腺癌的预后相关[4].本研究拟对胰腺癌患者血浆miRNA联合检测并评价其对胰腺癌的诊断价值.     

Evaluation of Serum Pancreatic Enzymes, Carbohydrate Antigen 19-9, and Carcinoembryonic Antigen in Various Pancreatic Diseases

Comparative studies of pancreatic enzymes carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) were performed in various pancreatic disease. In acute pancreatitis as well as during acute exacerbation of chronic pancreatitis, all pancreatic enzymes were abnormally high. In chronic pancreatitis, they did not have any diagnostic sensitivity for pancreatic insufficiency. In pancreatic carcinoma, serum elastase levels may have a diagnostic value compared with other pancreatic enzymes. In studies of CEA and CA 19-9, both tumor markers were within normal range in benign pancreatitis but 27.7% of CEA and 30.7% of CA 19-9 in acute pancreatitis were above normal. In pancreatic carcinoma, although most of these patients had advanced disease, both tumor markers were extremely high and 61% for CEA and 71% for CA 19-9 were above normal. In patients with resected pancreatic carcinoma, serum CEA was slightly higher than normal CA 19-9 was much higher than normal. The sensitivity of CEA and CA 19-9 in this group were 33 and 77.7%, respectively. The results indicate that the CA 19-9 assay is a useful adjunct in the diagnosis of pancreatic carcinoma, possibly in the resectable stage especially combined measurement of serum elastase and CEA.     

Determination of CA 19-9 antigen in serum and pancreatic juice for differential diagnosis of pancreatic adenocarcinoma from chronic pancreatitis

Serum CA 19-9 levels were measured in 63 patients with ductal pancreatic adenocarcinoma and in 49 patients with chronic pancreatitis. Concentrations were abnormally high (greater than 40 U/ml) in 57 (90%) patients with cancer and only in 5 (10%) patients with chronic pancreatitis. All patients with falsely normal serum values had poorly differentiated carcinomas. Median CA 19-9 concentrations were progressively higher in patients with more advanced cancer. Fifteen of 16 (93%) patients with localized cancer has abnormal serum levels but only 5 (31%) of them had values greater than 120 U/ml, which was the highest score observed in patients with chronic pancreatitis. Pure pancreatic juice was obtained endoscopically from 23 patients with pancreatic cancer and from 20 with chronic pancreatitis. CA 19-9 concentrations in pancreatic juice were significantly higher in patients with cancer than in non-neoplastic patients. All 11 patients with resectable cancer investigated had a ratio of CA 19-9 to secretory protein concentration in pancreatic juice above the range of patients with chronic pancreatitis. We conclude that serum CA 19-9 determination is highly sensitive and specific for the differential diagnosis of pancreatic cancer versus chronic pancreatitis. However, moderately increased values (less than 120 U/ml), as seen in patients with localized pancreatic adenocarcinoma, are not conclusive for malignancy. The measurement of CA 19-9 to total protein ratio in pure pancreatic juice is proposed as an adjunctive, accurate diagnostic marker for early stages of pancreatic adenocarcinoma.     

Serum tumor markers not useful in screening patients with pancreatic mucinous cystic lesions associated with malignant changes

BACKGROUND: Serum cancer antigen 19-9 (CA19-9) pro-vides additional information about mucinous cystic pancre-atic neoplasm (MPN). This study was undertaken to assess both CA19-9 and carcinoembryonic antigen (CEA) serum concentrations in consecutive patients affected by MPNs and other chronic benign and malignant pancreatic diseases. We also evaluated whether serum CA19-9 and CEA determina-tions provide additional information such as the presence of invasive carcinoma in MPN patients.
METHODS: Serum CA19-9 and CEA from 91 patients with pancreatic diseases were tested by commercially available kits at the time of diagnosis. The upper reference limit of serum CA19-9 was 37 U/mL and that of serum CEA was 3 ng/mL.
RESULTS: Thirty-ifve patients was diagnosed with chronic pancreatitis (CP), 32 with MPN, and 24 with pancreatic ductal adenocarcinoma (PDAC) conifrmed histologically. Surgery was carried out in 5 CP patients, in 10 MPN patients (7 of them had severe dysplasia), and 9 PDAC patients. Serum CA19-9 activity was high in 12 (34.3%) CP patients, in 7 (21.9%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.089). High se-rum CEA concentrations were noted in 6 (17.1%) CP patients, in 6 (18.8%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.010). In the 7 MPN patients associated with histological-ly conifrmed severe dysplasia, 3 (42.9%) patients had elevated serum activity of serum CA19-9, and 2 (28.6%) patients had high levels of CEA.
CONCLUSION: Serum determination of oncological markers is not useful in selecting MPN patients with malignant changes.     

肿块型慢性胰腺炎39例临床分析

目的 探讨肿块型慢性胰腺炎的临床特征.方法 回顾分析2005年1月至2007年12月间39例经手术病理证实的肿块型慢性胰腺炎患者临床表现、影像学及病理学资料,并与经手术病理检查证实的17例胰腺癌患者进行比较.结果 39例肿块型慢性胰腺炎和17例胰腺癌患者中黄疸分别有14例和1例.差异有统计学意义(χ2=0.111,P=0.045),血清癌胚抗原升高分别为0例和3例,糖链抗原(CA)19-9升高分别为12例和11例,差异均有统计学意义(P值均＜0.05);CT显示胰腺萎缩、胰腺周围及血管侵犯分别有0、5例和3、8例,差异均有统计学意义(P值均＜0.05).31例肿块型慢性胰腺炎和14例胰腺癌患者行磁共振胰胆管造影检查,胰管扩张、胰管中断、胆管扩张分别有14、2、15例和11、6、2例.差异均有统计学意义(P值均＜0.05).18例肿块型慢性胰腺炎和14例胰腺癌患者行超声内镜引导下细针穿刺检查,前者未找到肿瘤细胞,后者中10例发现恶性肿瘤细胞.结论 肿块型慢性胰腺炎诊断困难,结合临床特点、肿瘤血清标志物检查、影像学检查对诊断有一定帮助,尤其活组织病理检查有较高的诊断价值.     

Clinical significance of cathepsin E in pancreatic juice in the diagnosis of pancreatic ductal adenocarcinoma

BACKGROUND: It has been reported that cathepsin E (CTSE) is a non-secretory and intracellular aspartic proteinase found in the superficial epithelial cells of the stomach and that it is also expressed in pancreatic ductal adenocarcinoma. We evaluated the diagnostic value of CTSE in the pancreatic juice in the diagnosis of pancreatic ductal adenocarcinoma compared with that of CA19-9, carcinoembryonic antigen (CEA) and K-ras mutations. METHODS: One hundred and one patients (25 with pancreatic ductal adenocarcinoma and 76 with chronic pancreatitis) were examined for the diagnostic significance of CTSE in the pancreatic juice in the diagnosis of pancreatic ductal adenocarcinoma. Forty of 101 patients (15 with pancreatic ductal adenocarcinoma and 25 with chronic pancreatitis) were examined to compare the diagnostic value of various tumor markers in the pancreatic juice, namely CA19-9, CEA, K-ras mutations and CTSE. RESULTS: The detection frequency of CTSE was significantly higher in patients with pancreatic ductal adenocarcinoma (64.0%) than in patients with chronic pancreatitis (7.9%; chi2 = 34.76; P < 0.0001). The sensitivity, specificity and diagnostic accuracy of CTSE in the pancreatic juice for pancreatic ductal adenocarcinoma was 66.7, 92.0 and 82.5%, respectively. These values were more efficient in comparison with those of CA19-9, CEA and K-ras mutations. The main cause of the detection failure of CTSE in pancreatic ductal adenocarcinoma was obstruction of the main pancreatic duct. Sensitivity was 85.7% in patients without obstruction of the main pancreatic duct. CONCLUSIONS: Cathepsin E in the pancreatic juice is a novel marker for a definitive diagnosis of pancreatic ductal adenocarcinoma.     

Multiparametric tumor marker (CA 19-9, CEA, AFP, POA) analyses of pancreatic juices and sera in pancreatic diseases

With respect to their diagnostic utility CA 19-9, CEA, AFP and POA were determined in pancreatic secretions and serum of patients suffering from pancreatic cancer (n = 76/55) or chronic pancreatitis (n = 79/45) and of controls (n = 81/42), respectively. While the determination of AFP and POA both in pancreatic secretions and serum does not permit a differential diagnosis, serum CEA (greater than 10 ng/ml) and CA 19-9 (greater than 50 U/ml) levels were indicative of pancreatic cancer in 30% and 83%, respectively, with a rate of false positive results of 5% and 8.5% confined to the chronic pancreatitis patients. A combination of tumor marker analyses, that is, serum CA 19-9 (greater than 50 U/ml) and pancreatic secretion CEA (greater than 70 ng/ml), proved to be positive in 92.9% of tumor patients with a maximum of 10.5% false positives. Likewise, values of serum CA 19-9 (greater than 50 U/ml) and serum CEA (greater than 10 ng/ml) were found in 85.8% of the pancreatic cancer patients with only 8.8% false positives, which were confined to the chronic pancreatitis patients. These results indicate the superiority of multiparametric tumor marker analyses for the diagnosis of pancreatic cancer, especially when including new monoclonal antibody defined tumor markers.     

Comparison of tumor marker CA 242 with CA 19-9 and carcinoembryonic antigen (CEA) in pancreatic cancer

BACKGROUND/AIMS: Although there are a variety of tumor markers used for diagnosis of pancreatic carcinoma, the sensitivity and specificity of those markers have not yet reached an ideal level. The aim of this study was to compare the diagnostic value of CA 242 with CA 19-9 and CEA in the patients with pancreatic cancer. METHODOLOGY: Serum CA 242, CA 19-9 and CEA levels were determined in 135 subjects in the following groups: Pancreatic cancer (n = 40), cholangiocellular carcinoma (n = 15), hepatocellular carcinoma (n = 10), cirrhosis (n = 7), chronic active hepatitis (n = 7), choledochal stone (n = 12), chronic pancreatitis (n = 9), acute pancreatitis (n = 6), and healthy controls (n = 29). RESULTS: An elevated serum CA 242 concentration (> 20 U/mL) was found in 30 out of 40 (70%) (mean; 2163 +/- 838 U/mL) patients with pancreas cancer, in 11 out of 15 patients with cholangiocellular carcinoma (93.3%) (mean 916 +/- 529 U/mL), in none of patients with hepatocellular carcinoma and healthy controls. Slightly elevated CA 242 concentration was found in 6 out of 41 patients with benign hepatobiliary and pancreatic disease (range 0.4-97.8 U/mL) (1 acute pancreatitis, 2 chronic pancreatitis, 1 cirrhosis, 2 choledochal stone). Mean serum CA 242, CA 19-9 and CEA levels of the pancreas cancer group were significantly higher than those of the other groups except the cholangiocellular carcinoma group. There was no significant difference between the stage of pancreas cancer regarding mean serum CA 242, CA 19-9 and CEA level. There was positive correlation between serum CA 242 and CA 19-9 level. In the pancreas cancer, the sensitivity of CA 242, CA 19-9 and CEA was 75%, 80%, 40%, respectively and the specificity of those markers was 85.5%, 67.5% and 73%, respectively. CONCLUSIONS: In conclusion, the advantage of CA 242 compared to CA 19-9 is that its specificity is higher than that of CA 19-9 in the diagnosis of pancreas cancer.     

Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

AIM: To investigate whether tumor marker staining can improve the sensitivity of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) to diagnose pancreatic malignancy.METHODS: Patients who underwent EUS-FNA were retrospectively identified. Each EUS-FNA specimen was evaluated by routine cytology and stained for tumor markers p53, Ki-67, carcinoembryonic antigen (CEA) and CA19-9. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (PLR and NLR) were calculated in order to evaluate the performance of each test to detect malignancy.RESULTS: Sixty-one specimens had complete sets of stains, yielding 49 and 12 specimens from pancreatic adenocarcinomas and benign pancreatic lesions due to pancreatitis, respectively. Cytology alone had sensitivity and specificity of 41% and 100% to detect malignancy, respectively. In 46% of the specimens, routine cytology alone was deemed indeterminate. The addition of either p53 or Ki-67 increased the sensitivity to 51% and 53%, respectively, with perfect specificity, PPV and PLR (100%, 100% and infinite). Both stains in combination increased the sensitivity to 57%. While additional staining with CEA and CA19-9 further increased the sensitivity to 86%, the specificity, PPV and PLR were significantly reduced (at minimum 42%, 84% and 1, respectively). Markers in all combinations performed poorly as a negative test (NPV 26% to 47%, and NLR 0.27 and 0.70).CONCLUSION: Immunohistochemical staining for p53 and Ki-67 can improve the sensitivity of EUS-FNA to diagnose pancreatic adenocarcinoma.     

Estimation of Carbohydrate Antigen (CA) 19-9 Levels in Pure Pancreatic Juice of Patients with Pancreatic Cancer

Carbohydrate antigen (CA) 19-9 levels in pure pancreatic juice from patients with pancreatic cancer, chronic pancreatitis, and other diseases were determined, and their clinical value was assessed. CA 19-9 levels in pancreatic juice were generally very high, compared with those in serum. In addition, the pancreatic juice CA 19-9 levels in patients with pancreatic cancer were significantly higher than those in patients with chronic pancreatitis and other various diseases used as controls. The assay of pancreatic juice CA 19-9 seemed to be valuable in the diagnosis of pancreatic cancer, showing a diagnostic value approximately similar to that of the serum CA 19-9 assay and clearly superior to that of the serum or pancreatic juice carcinoembryonic antigen assay.     

内镜超声引导下细针穿刺抽吸术对胰腺癌的诊断价值

目的探讨内镜超声引导下细针穿刺抽吸术（EUS-FNA）对胰腺占位性病变特别是胰腺癌的诊断价值。方法对2005年后经B超、CT、MRI等影像学诊断和（或）临床疑诊胰腺癌的37例患者,在EUS引导下对病变作细针穿刺抽吸活检（FNA）,对于囊实性病变同时抽取囊液化验淀粉酶及肿瘤标志物等指标。结果EUS-FNA检出胰腺导管细胞癌16例,转移性肾细胞癌1例,可疑癌5例,异型细胞6例,正常胰腺组织6例,非胰腺成分3例。随访至2008年7月时,已证实胰腺癌25例,良性10例（慢性胰腺炎4例,囊腺瘤4例,假性囊肿2例）,尚有2例无法确诊。EUS-FNA诊断胰腺癌的敏感性为80．0％（95％CI：59．0-93．0）,特异性为100．0％（95％CI：60．0—100．0）,阳性预测值为100．0％（95％CI：80．0-100．0）,阴性预测值为55．6％（95％CI：27．0-79．0）。6例病变获取囊液进行淀粉酶、肿瘤标志物分析。本组EUS-FNA术后无严重并发症发生。结论EUS-FNA是一项安全有效的操作,对于胰腺占位性病变尤其是胰腺癌的诊断具有重要的意义。