胆汁CA19-9、CEA对胆管癌诊断价值的临床分析

The clinical analysis of bile CA19-9 and CEA in diagnosis of cholangiocarcinoma

目的通过临床分析探讨胆汁肿瘤标志物CA19-9、CEA检测对胆管癌的诊断价值。方法选择2008年9月至2010年4月于吉林大学中日联谊医院肝胆胰外科住院,经术后病理证实为胆管癌患者31例,同期胆道良性病变患者35例分别作为观察组和对照组,采用化学发光酶免方法检测两组患者血清和胆汁中CA19-9、CEA水平。结果观察组血清和胆汁中CA19-9、CEA水平明显高于对照组,差异有统计学意义(P<0.01),观察组胆汁CA19-9、CEA水平明显高于血清中两者水平,差异有统计学意义(P<0.01);联合检测胆汁CA19-9、CEA对胆管癌诊断的敏感性和特异性显著高于单独检测,差异有统计学意义。结论胆汁肿瘤标志物CA19-9、CEA的测定对胆管癌的诊断价值优于血清CA19-9、CEA的测定;胆汁CA19-9、CEA联合检测能显著提高对胆管癌诊断的敏感性和特异性,对提高胆管癌的检出率和胆管良恶性狭窄的鉴别诊断有重要价值。

Objective To evaluate the value of detecting tumor markers CA19-9and CEA in the bile for diagnosis of cholangiocarcinoma. Methods Chose 31 patients with bile duct carcinome conformed by pathological specimens in the Department of Hepatopancreatobiliary Surgery in The China-Japan Union Hospital of JiLin University from September 2008 to April 2010,over the same period 35 patients with benign bile duct,respectively,as the observation group and control group. chemiluminescence enzyme immunoassay （CLEIA） were used to detect the content of CA19-9 and CEA in bile and serum. Results There were significance in the bile and serum level of CA19-9 and CEA between the two groups（P0.01）. There were significance in the level of CA19-9 and CEA between the bile and serum of the observation group（P0.01）. Sensitivity and specificity of combined detection of bile CA19-9 and CEA were apparently higher than both of them of single detection.Conclusion The volue of bile CA19-9 and CEA in diagnosis of cholangiocarcinoma is superior than serum CA19-9 and CEA. Combined detection of bile CA19-9 and CEA can significantly improve sensitivity and specificity of cholangiocarcinoma and it has great valve to increase cholangiocarcinoma diagnosis rates and differentiate cholangiocarci-noma and benign bile duct stricture.