肿瘤标志物CA242与CA19-9对胰腺癌的诊断作用研究

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

目的：研究肿瘤标志物ＣＡ２４２与ＣＡ１９－９对胰腺癌的诊断作用。方法：选择１９９６年４月至１９９７年６月在北京医院门诊及住院的患者，共有１９７例进行了血清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的患者，１２例为急性胰腺炎患者，１８例为良性阻塞性黄疸患者。结果：胰腺癌患者血清ＣＡ１９－９和ＣＡ２４２较对照组明显增高，其中２５例胰腺癌患者有２１例ＣＡ１９－９阳性，检测的灵敏度为８４％，特异度为７４．４％，有１７例ＣＡ２４２阳性，检测的灵敏度为６８％，特异度为８７．８％。ＣＡ２４２与ＣＡ１９－９比较，灵敏度无显著区别（０．１０＜Ｐ＜０．２５）；而特异度则显著增高（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，且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度，增加诊断的可靠性。

From April 1996 to June 1997, 197 cases had their serum CA19-9 assayed and 148 cases had their serum CA242 assayed in our hospital, in which 25 cases were pancreatic cancer, 12 cases acute pancreatitis and 18 cases benign obstructive jaundice. The results showed that 21 cases out of 25 pancreatic cancer patients showed CA19-9 positive with a sensitivity rate of 84%and specificity rate of 74.4%, however, 17 cases of serum CA242 were positive with sensitivity of 68%and specificity of 87.8%. By comparison of serum CA242 and CA19-9,no significant difference was found in sensitivity (2=1.75, 0.10< P< 0.25),but specificity was significantly higher in serum CA242 (2=6.99, P< 0.01)In conclusion, serum CA242 is a more useful diagnostic parameter for pancreatic cancer because of its significantly higher specificity.