联合检测血清及胆汁中CA199和CEA对胆管癌诊断的临床意义

目的 探讨血清及胆汁中肿瘤标志物肿瘤抗原199 （cancer antigen 199,CA199）和癌胚抗原（carcino-embryonic antigen,CEA）联合检测对胆管癌诊断的临床意义.方法 选取胆管癌及胆管良性病变患者89例,于术前抽取血清样本、术中抽取胆汁样本,检测患者血清及胆汁中肿瘤标志物CA199和CEA水平,并比较其在胆管良恶性病变患者血清及胆汁中的变化规律.结果 胆管癌患者血清和胆汁CA199水平及CEA水平均显著高于胆管良性病变患者,差异均有统计学意义（P均＜0.05）.胆管癌患者和良性病变患者胆汁中CA199和CEA水平均显著高于其血清CA199和CEA水平,差异均有统计学意义（P均＜ 0.05）.血清和胆汁CA199及CEA联合检测诊断胆管癌的特异性均高于其单独检测,但敏感性较低.结论 患者血清及胆汁中CA199和CEA检测均可作为胆管癌的诊断指标,胆汁中CA199和CEA检测对胆管癌的诊断作用优于血清中上述指标,二者联合检测可提高胆管癌的诊断率.

Significance of combined detection of CA199 and CEA in serum and bile for diagnosis of cholangiocarcinoma

Objective To investigate the clinical significance of serum and bile tumor marker cancer antigen 199 （CA 199） and carcino-embryonic antigen （CEA） in the diagnosis of cholangiocarcinoma. Methods 89 patients with bile duct cancer and bile duct benign lesions were seclected. Serum and bile samples were taken before operation and during operation respectively. Serum and bile tumor markers CA199 and CEA levels were detected. The levels of tumor markers in patients with bile duct benign and malignant lesions were compared. Results The levels of serum and bile CA199, CEA in cholangiocarcinoma patients were significantly higher than that in patients with bile duct benign lesion （Pall〈 0.05）, The levels of CA199 and CEA in bile of cholangiocarcinoma patients and bile duct benign lesion patients were significantly higher than that in serum （Pall〈 0.05）. The specificity of CA199 combined detection with CEA in serum and bile were all higher than detection alone, but the sensitivity were lower. Conclusion The patient＇s serum and bile CA199 and CEA can be used as a diagnostic indicator of cholangiocarcinoma. Diagnostic value of tumor markers CA199 and CEA in bile are better than that in serum to cholangiocarcinoma. The two combined detection can improve the diagnosis of cholangiocarcinoma.