联合应用肿瘤标记物在胰腺癌诊断中的意义

ignificance of combined detection of tumor markers in diagnosis of the carcinoma of pancreas

目的探讨肿瘤标记物糖链抗原199（CA199）、肿瘤抗原242（CA242）与癌胚抗原（CEA）联合检测对胰腺癌诊断及预后判断的意义。方法用化学发光技术分别检测胰腺癌50例、胰腺良性疾病42例和健康体检者60例的血清CA199、CA242与CEA表达。结果胰腺癌组CA199、CA242与CEA等3种标志物血清值分别为（226．26±42．06）、（68．82±7．63）与（9．63±5．84）μg／L，均明显高于其他组（P〈0．05）；胰腺癌组CA199、CA242与CEA阳性率分别为82．61％、76．09％与60．87％，与其他两组比较，差异均有统计学意义（P〈0．05）；CA199、CA242与CEA等3项联检准确性达97．83％。CA199与胰腺癌分期呈正相关，与患者生存期呈负相关。结论肿瘤标志物联合检测可明显提高胰腺癌早期确诊率，CA199对判断预后有一定参考价值。

Objective To investigate the significance of combined detection of cancer antigen 199 （CA 199）, CA 242 and carcinoembryonic antigen （CEA） in the diagnosis and prognosis of the carcinoma of pancreas. Methods Chemical luminous technique was used in detecting the expression level of CA 199, CA 242 and CEA in the serum of 50 patients with pancreatic carcinoma （pancreatic carcinoma group）, 42 patients with benign pancreatic disease （benign disease group） and 60 healthy people （healthy control group） separately. Results The levels of the 3 tumor markers [ CA 199：（226.26 ± 42.06） vs （52.26 ± 15.32） or （ 10.12 ± 6.35） U/ml, CA 242 ： （68.82 ± 7.63） vs （ 18.25 ± 3.58） or （9.86 ± 4.67） U/ml, CEA： （9.63±5.84） vs （4.16±2.58） or （2.25 ±1.24） μg/L] in the pancreatic carcinoma group were significantly higher than those in other two groups （ all P 〈 0.05 ）. The positive rate of 3 tumor markers （CA 199： 82.61% , CA 242： 76.09% , CEA： 60. 87% ） in the pancreatic carcinoma group was significantly higher than those in other two groups （ all P 〈 0.05）. The rate of accuracy of the combined detection was 97.83%. The level of CA 199 was positively correlated with the stage of pancreatic carcinoma, but negatively with the life span of the patients. Conclusion Combined detection of the 3 tumor markers could obviously improve the early diagnosis of pancreatic carcinoma, and CA 199 is of some reference value in judging the prognosis.