CEA联合CA19-9检查在胆胰腺癌诊断中的价值

目的探讨CEA联合CA19-9检查在胆胰腺癌诊断中的价值。方法收集2012年8月至2015年7月贵州省人民医院肝胆外科收治的B超、CT、MRI等影像学检查提示胆道梗阻和胆道、胰腺占位,行CEA、CA19-9检查的患者800例,结合病理结果回顾性分析CEA联合CA19-9检查对胆胰腺癌诊断的准确率。结果单独CEA阳性(3.40μg/L)时,胆胰腺癌的诊断准确率为27.78%;单独CA19-9阳性(39.00 U/mL)时,胆胰腺癌的诊断准确率为35.43%;CEA和CA19-9均阳性时,胆胰腺癌的诊断准确率为85.71%;当提高阳性设定值CEA3.50μg/L,CA19-9200.00 U/mL时,胆胰腺癌的诊断准确率为95.42%。CEA和CA19-9同时阳性且持续升高时,依据之前的两组阳性设定值,胆胰腺癌的诊断准确率分别为95.91%和98.41%。结论 CEA联合CA19-9检查能够显著提高胆胰腺癌诊断的准确率,尤其当CEA3.50μg/L同时CA19-9200.00 U/mL,而且二者持续升高时。

Value of CEA combined with CA19-9 examination in the diagnosis of biliary and pancreatic cancers

Objective To explore the value carcinoembryonic antigen (CEA) combined with cancer antigen 19-9 (CA19-9) examination in the diagnosis of biliary and pancreatic cancers. Methods The study included 800 patients who diagnosed as benign (malignant) biliary obstruction or (and) space-occupying lesions in the bili-ary tract or pancreas by ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI), and then underwent CEA and CA19-9 examinations in Guizhou Provincial People's Hospital between Aug. 2012 and Jul. 2015. The diagnosis accuracy of CEA and CA19-9 combined examination on the biliary and pancreatic cancers was retrospectively evaluated by pathological results. Results The diagnosis accuracy of biliary and pancreatic cancers was 27.78% with only CEA positive (>3.40 μg/L), and 35.43% with only CA19-9 positive (>39.00 U/mL), the combined diagnosis accuracy was 85.71% when the positive value set higher CEA (>3.50μg/L and CA19-9>200.00 U/mL), the combined diagnosis accuracy was 95.42%. When the levels of CEA and CA19-9 were continuously increasing, the diagnostic accuracy rate of biliary and pancreatic cancers significantly increased, according to above two positive value sets, were 95.91% and 98.41%, respectively. Conclusion The combined examination CEA and CA19-9 can significantly increase the diagnosis accuracy rate of biliary and pancreatic cancers, especially for the patients with both CEA>3.50 μg/L and CA19-9>200.00 U/mL and CEA and CA19-9 increasing continuously.