血清胆汁CA19-9、CEA、CA242联合检测诊断胆道良恶性肿瘤的可行性分析

目的:探讨血清、胆汁CA19-9、CEA、CA242联合诊断胆道良恶性肿瘤的临床价值。方法:对象为2013年10月-2015年2月来我院诊治的疑似恶性胆道肿瘤的患者202例，均行手术探查。所有患者均通过穿刺的方式取胆汁进行CA19-9、CEA、CA242检测，比较不同疾病类型患者血清、胆汁中的CA19-9、CEA、CA242检测水平，分析血清胆汁联合检测在胆道良恶性肿瘤中的诊断价值。结果:202例手术探查患者中，98例经病理证实为恶性胆道肿瘤患者、22例为良性胆道肿瘤患者，82例为其他胆道疾病。恶性胆道肿瘤与良性胆道肿瘤患者胆汁中CA242、CA19-9和CEA的表达水平要显著性的高于在血清中的表达水平（P＜0.05）；恶性肿瘤组患者的胆汁中CA242、CA19-9和CEA检测水平均显著性高于良性肿瘤患者（P＜0.05)；胆汁CA242、CA19-9和CEA联合诊断胆道恶性肿瘤的敏感率为33.66%，准确率为88.98%，特异性为91.16%，阳性率为35.24%。结论:利用胆汁中肿瘤标记物对胆道肿瘤的检测水平要高于血清中的水平，采用CA19-9、CEA、CA242的联合检测是诊断胆道肿瘤比较理想的组合。上述肿瘤标志物的组合能够提高胆道肿瘤良恶性的预判准确度，对于早期胆道良恶性肿瘤的发现、治疗具有十分重要的意义。

Clinical value of serum bile CA19 -9,CEA,CA242 detection in benign and malignant bili-ary tumor

Objective:To investigate the value of serum,bile CA19-9,CEA,CA242 in benign and malignant biliary tumor.Methods:All 202 patients were taken bile puncture and tested for CA19-9,CEA,CA242,Results:Of 202 cases of surgical exploration patients,98 patients with pathologically proven malignant biliary cancer,22 cases of benign biliary cancer,82 cases of other biliary tract disease.Malignant bile duct cancer and patients with benign bile duct cancer bile in CA242,CA19-9 and CEA expression level was significantly higher than in the serum levels(P＜0.05).Patients with malignant bile CA242,CA19-9 and CEA levels were significantly higher in patients with benign tumors(P＜0.05).Bile CA242,CA19-9 and CEA in diagnosis of biliary cancer sensitivity was 33.66%,accuracy was 88.98%,specificity 91.16%,the positive rate was 35.24%.Conclusion:Bile levels of tumor markers for bile duct cancer are higher than levels in serum,using CA19-9,combined detection of CEA,CA242 diagnosis of bile duct cancer is an ideal combination.