胆管癌患者血清CA19-9水平的动态变化及其临床意义

目的探讨胆管癌患者血清肿瘤标志物糖类抗原CA19-9水平及其与临床特征的关系,评价其在疾病进展及疗效观察中的意义。方法采用全自动化学发光免疫分析仪测定2009年10月～2011年10月52例确诊初治的胆管癌患者的血清CA19-9水平,观察不同临床分期胆管癌患者CA19-9水平,并与50例健康对照及50例胆道良性疾病患者相比较,分析CA19-9水平与临床特征及临床分期的关系。结果胆管癌组患者血清CA19-9水平为(284.3±62.2)U/ml,明显高于健康对照组的(18.5±6.3)U/ml和胆道良性疾病患者的(94.4±5.5)U/ml,差异有统计学意义(P﹤0.05)。不同临床分期胆管癌患者血清CA19-9水平I期为(124.6±51.2)U/ml,Ⅱ～Ⅲ期为(308.2±65.3)U/ml,Ⅳ期为(354.7±68.5)U/ml,I期与Ⅱ～Ⅲ期及Ⅳ期比较,差异有统计学意义(P﹤0.05),Ⅱ～Ⅲ期与Ⅳ期比较,差异无统计学意义(P﹥0.05)。结论血清CA19-9检测对胆道癌的筛查以及临床分期有一定的价值,对CA19-9水平进行动态检测或肿瘤标志物联合检测有助于进一步明确诊断。

Dynamic changes and clinical significance of cholangiocarcinoma in patients with serum CA19-9 levels

OBJECTIVE To investigate the relationship between bile duct cancer in patients with serum tumor markers carbohydrate antigen CA19-9 level and its with clinical characteristics,and evaluate its significance in disease progression and therapeutic response.METHODS Automatic chemistry immunoassay analyzer was used for determination of 52 patients cholangiocarcinoma from October 2009 to October 2011.The serum CA19-9 level was analyzed,and the CA19-9 level of different clinical stages were observed.50 cases of healthy controls and 50 cases of benign biliary tract disease were collected.The CA19-9 level was compared with the clinical characteristics and clinical stage.RESULTS The serum CA19-9 level of cholangiocarcinoma patients was(284.3 ± 62.2)U/ml,which was significantly higher than that of the healthy control group(18.5 ± 6.3)U/ml,and was(94.4 ± 5.5)U/ml in patients with bile duct benign disease.There was significant difference(P﹤0.05).The serum CA19-9 levels of different clinical stages of cholangiocarcinoma patients were(124.6 ± 51.2)U/ml for I stage,(308.2 ± 65.3)U/ml for II-III stage,and IV(354.7 ± 68.5)U/ml for IV stage.When compared with I and stage Ⅱ-Ⅲ and Ⅳ,there was significant difference between them(P﹤0.05).When compared with II-III with Ⅳ,there was no significant difference(P﹥0.05).CONCLUSION The serum CA19-9 detection of bile duct cancer screening and clinical stage have a certain value for dynamic detection of tumor markers,CA19-9 levels were simultaneously detected.The diagnosis needs further clarification.