CEA.CA_(19-9)对胆囊癌的诊断价值

The Diagnostic Value of CEA & CA_(19-9) to Cholecystocarcinoma

经手术病理证实的胆囊癌53例,皆为腺癌,其中高、中分化型为94.4％,低分化型为5.6％;病变浸润深度:粘膜内癌(m)1.9％、固有肌层癌(Pm)5.6％,浆膜下层癌(SS)22.1％,浆膜癌(S)70.4％。术前进行了癌胚抗原(CEA)和糖链抗原(CA_(19-9))的测定,其阳性率CEA为54.1％,CA19—9为81.3％,而且早期胆囊癌也可以呈现阳性,并且随着病变对胆囊壁浸润深度的增加,其阳性率增高。

The article reported 53 cases of cholecystocarcinoma confirmed by operation and pathology at the First Surgical Department of Kyuahu University between 1980 and 1990. Among them,24 cases were male and 29 caes were female aged 20—80 year old. All were adenocarcinoma, among which 94.4% were of high and moderate differentiative type and 5.6% of low differentiation. The clinical staging of the cases was distributed as follows: stage Ⅰ 16.7% stage Ⅱ 5.6%, stage Ⅲ 25.8% and stage N 51.9%. The infiltrative depth were: mucous carcinoma occupied 1.9%, the proper muscle layer 5.6%, subserous carcinoma 22.1% and serous carcinoma 70.4%. The serum CEA content was determined preoperatively by EIA, and the positive rate is 54.1%. The serum CA_(19-9)was also determined by RIA with the positive rate 81.3%. The article studied the diagnostic value of CEA and CA_(19-9) to cholecystocarcinoma according to the results determined: (1) CEA, especially CA_(19-9) reveals high positive rate in the diagnosis of cholecystocarcinoma, and is of clinical practical value to qualitive diagnosis of cholecystocarcinoma. (2) CEA and CA_(19-9)may show positive in the early stage of cholecystocarcinoma (mucous and proper muscle layer carcinoma), so they are significant to the early diagnosis of cholecystocarcinoma. (3) The determination of serum CEA and CA_(19-9) in case of polypoid lesion of gallbladder may avoid delay of operative opportunity, so operation can be performed timely and the prognosis can be improved. (4) The posirive rate of CEA and CA_(19-9) increases as the infiltrative depth deepens, which is of instruive significance to the selection of operative type.