CA19-9和CA125在胰胆管疾病中表达的相关性研究

Expression and Clinicopathologic Significance of CA19-9 and CA125 in Benign and Malignant of Biliopancreatic Lesion

目的:探讨胰胆管疾病患者血清以及样本组织中CA19-9和CA125的检测对胰胆管疾病的诊断价值。方法:对74例胰胆管疾病患者进行血清CA19-9和CA125水平的检测,并对其中31例在治疗中切除了全部或部分肿瘤的患者组织样本进行CA19-9和CA125水平的检测,以及上述2个指标的免疫组化测定。结果:在判断胰胆管恶性疾病方面,CA19-9的敏感性、特异性及阳性和阴性预测值分别为87.10%、58.14%、60.00%和86.21%;而CA125敏感性、特异性及阳性和阴性预测值分别64.52%、81.40%、71.43%和76.09%;CA19-9和CA125联合检测的敏感性、特异性分别为80.00%和72.22%。在恶性组织中,运用免疫组织化学染色法检测CA19-9和CA125的表达,其结果分别为74.19%和54.84%(P<0.05)。结论:CA19-9和CA125对检测胰胆管疾病的敏感性与特异性均较高,可联合超声与CT等影像学检查对胰胆管疾病进行比较准确的诊断。

Objective： To investigate the clinicopathologic utility of two neoplastic markers（CA19-9 and CA125） in benign and malignant of biliopancreatic lesions.Methods： Biliopancreatic disease patients were assigned into malignant（n=31） or benign（n=43） groups based on cytological and histological evaluation of biliopancreatic lesion samples.The serum from each patient was tested for CA19-9 and CA125.Serum levels of CA19-9 and CA125 were determined in all 74 patients,and CA19-9 and CA125 expression in tissue samples were also determined in 31 malignant cases who underwent biopsy or open surgery.The sensitivity,specificity,positive and negative predictive values of each test in the differential diagnosis was determined.Results： The sensitivity,specificity,positive predictive value,and negative predictive value of CA19-9 were 87.10%,58.14%,60.00%,and 86.21%,respectively,and those of CA125 were 64.52%,81.40%,71.43%,and 76.09%,respectively.The sensitivity and specificity of CA19-9 plus CA125 tests were 80.00% and 72.22% respectively.In the malignant tissues,the positive rates of the CA19-9 and CA125 antigens detected by IHC test were 74.19% and 54.84% respectively（P0.05）.Conclusion： Taking into account the high but still limited sensitivity and specificity of the CA19-9 and CA125 test,their results in the differential diagnosis of biliopancreatic tumors should be interpreted consistently and in reference to imaging techniques such as ultrasonography and computer tomography.