胰胆系不同疾病之间肿瘤标志物水平比较研究

Compare the Levels of Tumor Markers in Different Pancreatic and Biliary Diseases

目的探讨各肿瘤标志物对胰胆系不同疾病诊断效能及其潜在其它临床应用价值。方法对我院2008年4月-2008年11月间119例不同胰胆系疾病患者,肿瘤患者均为术前血清标本,良性疾病患者采血前均无ERCP等有创检查或治疗,常规离心分离血清进行检测。利用美国雅培公司化学发光分析仪器及配套试剂进行检测,诊断标准以CA199>37(U/ml)、CA125>35(U/ml)、CEA>10(ng/ml)水平为阳性。结果①胰腺不同疾病间,比较各组之间肿瘤标志物等水平差异,统计分析结果,CA199(χ=28.113,P=0.000),CA125(χ=9.752,P=0.008),CEA(χ=8.632,P=0.013),其肿瘤指标均有统计学差异;②胆系不同疾病间,肿瘤组肿瘤标志物指标各平均秩次胆系肿瘤组均高于胆总管结石组,但均无统计学差异(P>0.05)。③胰腺肿瘤组与胆系肿瘤组比较,各肿瘤指标非参数检验结果分别为CA199(Z=0.312,P=0.755),CA125(Z=0.745,P=0.456),CEA(Z=0.491,P=0.624)但各肿瘤标志物水平间无统计学差异(P>0.05)。④慢性胰腺炎与慢性胰腺炎伴假囊肿患者之间,非参数检验结果显示CA125水平之间具有统计学差异(Z=1.970,P=0.048);而假性囊肿与胰腺囊肿之间各指标均无统计学差异(P>0.05)。结论①CA199虽然其诊断胰腺癌特异性较差,但在胰腺良恶性疾病方面对胰腺癌诊断具有较大优势。②各肿瘤指标对胆系良恶性疾病及胰胆肿瘤的诊断效能较低,单独应用不能准确鉴别胆系良恶性疾病及胰胆肿瘤。③CA125指标监测胰腺炎有无继发假性囊肿形成的价值,有待临床进一步研究证实。

Objective To evaluate the diagnosis interpretation and clinic application of serum tumor markers in different pancreatic and biliary diseases.Methods We detected tumor markers CA199,CA125 and CEA in 119 patients with benign and malignant pancreatic and biliary diseases. All the test of tumor markers and related reagents are used by chemiluminescent microparticle immunoassay（CMIA）to analysis the levels of tumor markers in different pancreatic and biliary diseases. Results The serum CA199, CA125,CEA levels in malignant of pancreatic diseases than benign diseases（ P 〈0.05）.But there were no significntly statistical dif- ference between benign and malignant biliary diseases.Interestingly,the serum CA125 level were also significntly higher in the chronic panreatitis with or without pseudocyst（ P 〈 0. 05 ）. Conclusion The serum level of CA199 is helpful to differential leisions of pancreatic diseases.he serum CA125 level maybe useful to supervise the formation of pseudocyst.