双抗体夹心法检测胆管癌患者血清中胆管癌相关抗原的临床意义

Clinical significance of detection of serum cholangiocarcinoma related antigen in patients with cholangiocarcinoma

胆管癌相关抗原（ＣＣＲＡ）是我们从人胆管癌组织中提取的一种新的肿瘤标志物。建立了检测ＣＣＲＡ的ＥＬＩＳＡ方法，检测了４０例正常人及２６８例良恶性疾病病人血清的ＣＣＲＡ浓度，后者包括胆管癌３６例、原发性肝癌４０例、胰腺癌２６例、胃癌３１例、结直肠癌３４例、肺癌１７例、肝硬变２０例、胆石症４０例及胃溃疡２４例。结果显示：４０例正常对照组的血清ＣＣＲＡ浓度为（１４．３８±７．３４）μｇ／ｍｌ（ｘ±ｓ），正常上限为２８．９５μｇ／ｍｌ（ｘ＋２ｓ）；血清ＣＣＲＡ诊断胆管癌的敏感性是７７．７８％，明显高于其它肿瘤组（０～２５）％（Ｐ＜０．００１），特异性是（７５～１００）％。认为对于胆管癌的诊断，ＣＣＲＡ可能是一种较特异的肿瘤相关抗原。

Cholangiocarcinoma related antigen (CCRA) is a new tumor marker isolated from human cholangiocarcinoma tissue. The double antibody enzyme linked immunoassay (ELISA) was established to detect the serum CCRA of 40 normal subjects and 268 patients who were consisted of 36 with cholangiocarcinoma, 40 primary hepatocellular carcinoma, 26 pancreatic cancer, 31 gastric cancer, 34 colorectal cancer, 17 lung cancer, 20 liver cirrhosis, 40 cholelithiasis and 24 gastric ulcer. It was found that the concentration of serum CCRA and its cut off value were (14.38±7.34) μg/ml ( ±s ) and 28.95 μg/ml ( +2s ) respectively in the normal controls. The diagnostic sensitivity of serum CCRA to cholangiocarcinoma was 77.78%, which was significantly higher than that to other diseases ( P <0.001) and the specificity was 75%￣100%. These findings suggest that CCRA might be a specific and useful tumor related antigen for the diagnosis of cholangiocarcinoma.