晚期膀胱癌患者血清CA19-9测定的临床意义

目的：探讨晚期膀胱癌患者血清CA19-9检测的临床意义.方法：采用电化学发光法测定41例晚期膀胱癌患者外周血 CA19-9水平,并对其临床意义进行分析.结果：本组患者CA19-9测定值为（77.1±194.3）IU/ml,其中CA19-9阳性19例,阳性率为46.3% 对照组CA19-9测定值为（13.6±5.2）IU/ml,阳性率为0,两组相比差异有显著统计学意义（P＜0.01）.病理检查证实淋巴结转移的11例患者CA19-9阳性率为54.5%,阴性组为14.2%,两组相比差异有统计学意义（P＜0.05）.6例远处器官转移的患者中有5例CA19-9阳性,阳性率为83.3%,与无远处转移的患者相比,阳性率差异有统计学意义（P＜0.05）.41例患者随访3～46个月,CA19-9阳性组、阴性组3年生存率分别为52.1%和85.9%,差异有统计学意义（P=0.036）.结论：血清CA19-9水平与肿瘤的进展以及预后密切相关,可能是判断晚期膀胱癌生物学行为的一项有用的指标.

Clinical Significance of Elevating Serum CA19-9 in Patients with Advanced Bladder Cancer

Objective：To evaluate the clinical significance of serum CA19-9 as a tumor marker in patients with advanced bladder cancer. Methods： F＇rom Jan 2006 to May 2009, 41 patients with advanced transitional celt carcinoma had preoperative CA19-9 serum assays performed. The association between the serum level of CA19-9 and clinical features were studied. Results：The serum CA19-9 level in 41 patients was（77.1± 194.3）IU/ml and the positive rate was 46.3%（19/41）. The serum level in superficial cancer group was（ 13.6±5.2）IU/ml and the posi- tive rate was 0%. The level and positive rate were significantly higher in the advanced bladder group in comparison to the superficial cancer group （P〈0. 01）. The positive rate of CA19-9 in 11 eases which proved regional lymph node metastasis after operation was 54.5 %,There was significant difference between the presence and absence of lymph node metastasis groups（P〈0. 05）. Distant metastasis was found in the lung in 2 cases, the liver,in 3 cases and the distance lymph node in 1 case. The positive rate of CA19-9 was 83. 3% in this group. The 3-year survival rate of CA19-9 positive group and negative group was 52.1%, 85.9% ,respectively, there was significant differ- ence between two groups （P= 0. 036）. Conclusions： Increased CA19-9 is more commonly found in patients with lymph node positive or distant metastasis. Prognosis is significantly poor in the patients with elevating serum CA19-9 level. CA19-9 may predict the biological behavior of advanced bladder cancer.