外周血内CA19-9、CA242及CEA对胰腺癌诊断及病理分期评估的价值

目的：分析糖类抗原19-9（carbohydrate antigen 19-9，CA19-9）、CA242、癌胚抗原（carcino-embryonic anti-gen，CEA）联合检测诊断胰腺癌的临床价值及其对临床分期判断的指导作用。方法选取95例胰腺癌患者为患者组，及同期60例健康体检者为对照组，比较两组受试者血清CA19-9、CA242和CEA的表达水平，计算血清CA19-9、CA242、CEA单独检测及联合检测诊断胰腺癌的敏感度、特异度和准确性，并比较不同临床分期胰腺癌患者血清CA19-9、CA242、CEA的差异，评价上述指标对胰腺癌临床分期判断的指导作用。结果患者组血清 CA19-9、CA242、CEA水平均高于对照组，差异均具有统计学意义（均P＜0．05）。联合检测诊断胰腺癌的敏感度、特异度和准确性分别为96．8％、66．7％、85．2％，其敏感度、准确性均优于单项检测。随着患者病理分期的增加，其血清CA19-9、CA242、CEA水平均升高，差异均具有统计学意义（均P＜0．05）。患者组治疗后6个月血清CA19-9、CA242、CEA水平均较术前降低，差异均具有统计学意义（均P＜0．05）。肿瘤直径≥5 cm者、肿瘤位于胰腺体／尾部者，其血清CA19-9、CA242、CEA水平均高于肿瘤直径＜5 cm 者及肿瘤位于胰腺头部或全胰腺者，差异均具有统计学意义（均 P＜0.05）。结论联合检测血清CA19-9、CA242和CEA有助于胰腺癌的早期诊断及分期判断，具有较高的临床价值。

Clinical value of peripheral blood CA19-9,CA242 and CEA levels for the diagnosis and pathologic staging of pancreatic cancer

Objective To analyze the clinical value of carbohydrate antigen 1 9-9 (CA1 9-9),CA242 and carcinoem-bryonic antigen (CEA)combined detection in the diagnosis and clinical staging of pancreatic cancer.Methods Ninety-five cases of pancreatic cancer patients were selected as the patient group,and 60 cases of healthy subjects were enrolled as the control group.The expression levels of serum CA1 9-9,CA242,and CEA were compared between the two groups.The sensitivity,specificity and accuracy of serum CA1 9-9,CA242 and CEA detection alone and combined detection in the diag-nosis of pancreatic cancer were analyzed.Besides,the serum levels of the above biomarkers were compared in pancreatic cancer patients of different clinical stages.The role of these antigens in the clinical staging of pancreatic cancer was further evaluated.Results The serum levels of CA1 9-9,CA242 and CEA in the patients were significantly higher than those in the control group (P<0.05).The sensitivity,specificity and accuracy of biomarkers combined detection in diagnosing pan-creatic cancer were 96.8%,66.7% and 85.2%,respectively,and both the sensitivity and accuracy were higher than those of a single test.As the pathological stages of pancreatic cancer patients increased,the serum levels of CA1 9-9,CA242 and CEA were all significantly increased (P<0.05 ).Moreover,at 6 months after treatment,the serum levels of CA1 9-9, CA242 and CEA were significantly decreased,compared with those before treatment (P<0.05).Furthermore,patients with tumors ≥5 cm in diameter,or tumors located in the pancreatic body or tail,showed significantly higher levels of serum CA1 9-9,CA242 and CEA,compared to those patients with tumors <5 cm in diameter or tumors in the pancreatic head or the entire pancreas (P<0.05).Conclusion The combined detection of serum CA1 9-9,CA242 and CEA has important clinical value in the early diagnosis and staging of pancreatic cancer.