血清肿瘤标志物CA19—9在胰腺癌诊断和预后中的价值

目的探讨检测血清肿瘤标志物癌抗原19—9（CA19—9）在胰腺癌诊断和预后中的作用。方法回顾性分析了105例胰腺癌患者、70例非胰腺外分泌恶性肿瘤患者以及30例胰腺良性疾病患者术前血清CA19—9的水平。结果血清CA19—9在胰腺癌患者中的表达水平显著高于胰岛细胞瘤、壶腹癌以及良性胰腺疾病患者（P〈0．05），而与肝外胆管癌患者的CA19—9水平无显著差异（P〉0．05）。CA19—9对胰腺癌诊断的敏感性和特异性分别为80％和43％。CA19—9在胰体尾癌患者中的表达水平显著高于胰头癌患者（P〉0．05）。CA19—9不受肿瘤大小以及可切除性的影响（P〉0．05），但在Ⅳ期胰腺癌患者中明显提高（P〈0．05）。结论CA19—9对胰腺癌的诊断具有一定的作用，但特异性不高，高水平的CA19—9提示病期较晚，预后不良。

The clinical value of serum CA19-9 in the diagnosis and prognosis of pancreatic cancer

Objective Serum tumor marker carbohydrate antigen 19 -9 （CA19 -9） was investigated to evaluate the values for the diagnosis and prognosis of pancreatic cancer. Methods Preoperative serum CA19 -9 was measured in 105 pancreatic cancer, 70 non - pancreatic malignance, and 30 benign panereatie diseases. Results The level of CA19 - 9 in pancreatic cancer was markedly higher than that of islet cell carcinoma, ampulla of rater carcinoma, and benign pancreatic diseases （ P 〈0. 05 ）, but was no significant difference with that of extrahepatic cholangiocarcinomas （ P 〉0.05）. The sensitivity and specificity of CA19 -9 for the pancreatic cancer were 80% and 43% respectively. The level of CA19 -9 in pancreatic cancer of head was higher than that of pancreatic cancer of body and tail. There was no significant relationship with the tumor size and resectabillty （ P 〉 0.05） , but the level of CA19 -9 was increased obviously （ P 〈 0.05 ）. Conclusion Serum CA19 -9 has a significant role for pancreatic cancer diagnosis, but the specificity is low. High level of CA19 -9provides the clue for advanced stage and poor prognosis.