肿瘤标志物CA242与CA19-9对胰腺癌的诊断价值

The Diagnostic Value of Serum Levels of CA242 and CA19-9 in Patients with Pancreatic Cancer

目的:比较血清肿瘤标志物CA242与CA19-9对胰腺癌的诊断价值。方法:1996年4月至1997年6月,北京医院对门诊及住院197例患者进行了血清CA19-9的检测,148例进行了CA242的检测,其中25例为临床明确诊断为胰腺癌,12例为急性胰腺炎,18例为良性阻塞性黄疸。结果显示:胰腺癌患者血清CA19-9和CA242较对照明显增高,其中25例胰腺癌患者有21例CA19-9阳性,检测的灵敏度为84％,特异性为74.4％,有17例CA242阳性,检测的灵敏度为68％,特异性为87.8％。CA242与CA19-9比较,灵敏度无显著差异(0.10<P<0.25);而特异性则显著增高(P<0.01)。12例急性胰腺炎患者有4例血清CA19-9阳性(33.3％),但CA242仅1例阳性(8.33％)。18例良性梗阻性黄疸患者CA19-9有16例阳性(88.8％),而CA242检测仅2例阳性(11.1％)。结论:血清CA242和CA19-9可用于胰腺癌的诊断。CA242对胰腺癌的诊断优于血清CA19-9;在不显著影响检测的灵敏度的情况下,可显著提高诊断的特异性,增加诊断的可靠性。

Background/Aims: To compare the reliability of serum CA242 with CA19-9 in the diagnosis of pancreatic cancer. Methods: From April, 1996 to June, 1997, a total 197 cases of serum CA19-9 and 148 cases of serum CA242 were assayed in our hospital, in which 25 cases were pancreatic cancer, 12 were acute pancreatitis and 18 were benign obstructive jaundice. Results: 21/25 patients with pancreatic cancer were CA 19-9 positive, sensitivity was 84% and specificity 74.4%. 17 cases were CA242 positive with sensitivity of 68% and specificity of 87.8%; in comparison, there was no significant difference in sensitivity (X2 = 1.75, 0.10<P<0.25), whereas specificity was significantly higher in serum CA242 (X2=6. 99, P<0.01). Conclusion: Serum CA242 is a more useful tumor marker in diagnosis of pancreatic cancer owing to its higher specificity.