胆汁和血清中CEA、CA19—9测定在胰胆管良恶性疾病中的鉴别诊断意义探讨

目的探讨胆汁和血清的CEA、CA19-9测定对胰胆管良恶性疾病的鉴别诊断价值。方法选取于我院行ERCP治疗的97例胰胆管良性疾病和33例引起胆管挟窜的胰胆管恶性疾病患者，收集其血液和胆汁标本，采用放射免疲法（RIA）和免疲放射法（IRMA）分别测定CEA和CA19-9含量。结果胆汁CEA在良恶性组中的平均值分别为（42．20＋24．51）ng／mE、（58．35＋34．48）ng／mL，血清的CA19—9在良恶性纽中的平均值分别为（112．99＋250．48）U／mL、（397．68＋96．99）U／mL，两者差异均有统计学意义（P=0．017，P=0．007），联合检测胆汁CEA和血清CA19-9能明显提高胰胆管恶性疾病的阳性预测值（71．4％）。结论胆汁CEA和血清的CA19-9检测有助于胰胆管良恶性疾病的羹别诊断。

The value of serum and biliary carcinoembryonic antigen and carbohydrate antigen19-9 for differentiation between benign and malignant biliary-pancreatic diseases

Objective To investigate the value of serum and biliary tumor markers for differentiation between benign and malignant biliary-pancreatic diseases.Methods We collected serum and bile from 97 cases with benign biliary-pancreatic lesion and 33 cases with malignant biliary tract neoplasm who were all referred for endoscopic retrograde c （ERCP）, CA19-9 and CEA levels were measured with Immuno-radiometric （IRMA） and Radioimmunoassay （RIA） .Results Biliary CEA levels were 42.20＋24.51ng/mL, 58.35＋34.48ng/mL each in benign and malignant biliary-pancreatic disease,while serum CA19-9 levels were 112.99＋250.48 U/mL 、 397.68＋96.99 U/mL each in benign and malignant biliary disease,The difference for both valueswas significant （P=0.017,P=0.007） , positive predictive value can be elevated obviously in condication of measuring biliary CEA and serum CA19-9 together. Conclusion Measurment of biliary CEA and serum CA19-9 is valuable for differentiation between benign and malignant biliary-pancreatic disease.