血清CA19-9、CEA水平与意外胆囊癌转移的关系研究

Prediction of preoperative neoplasm metastasis in patients with unexpected gallbladder carcinoma by determination of serum CA19-9 and CEA levels, report of 60 cases

目的探讨意外胆囊癌转移与血清CA19-9、CEA水平的关系。方法对2002年8月至2006年6月收治的60例意外胆囊癌患者的临床资料进行回顾性分析,将血清CEA≥10ng/ml及CA19-9≥37U/ml者做为异常（阳性组）,组间比较采用χ^2检验,P〈0.05为差异有统计学意义。结果35例（58%,35/60）意外胆囊癌再手术后发现肿瘤转移。CA19-9阳性组及CA19-9阴性组肿瘤转移率分别为93%（27/29）及26%（8/31）,两组比较差异有统计学意义（P〈0.05）;CEA阳性组及CEA阴性组肿瘤转移率分别为92%（12/13）及49%（23/47）,两组比较差异有统计学意义（P〈0.05）。结论意外胆囊癌转移率与血清CA19-9及CEA水平有关,CA19-9可用于术前判断意外胆囊癌转移,与CEA联合应用可以提高诊断准确率。

Objective To evaluate the prediction of preoperative neoplasm metastasis of unexpected gallbladder carcinoma（UGC） by the measurement of serum CA19-9 and CEA levels. Methods Clinical data of 60 cases of UGC from 2002. 8 - 2006.6 were retrospectively analyzed. CEA ≥ 10 ng/ml and CA19-9 ≥37 U/ml were defined as abnormal. χ^2 was used and a P value less than 0. 05 was regarded as significant. Results The neoplasm metastasis rate of UGC accounted for 58.3% （ 35/60 ） as found by following surgery. Neoplasm metastasis was 93% （27/29）in patients with CA19-9 （ ＋ ）as compared with 26% （8/31）in those with CA19-9（ - ） patients（P 〈0. 05） ; The neoplasm metastasis rate of CEA （ ＋ ） and CEA（ - ） group were 92% （12/13）and 49% （23/47）respectively（P 〈0.05）. Conclusions In cases of unexpected gallbladder carcinoma, abnormally high level of serum CA19-9 and CEA concentration may predict a cancer matastasis.