多种肿瘤标志物联合检测对肝门胆管癌诊断的意义

Diagnostic value of combination detection of multiple tumor markers for hilar cholangiocarcinoma

目的:探讨联合检测肿瘤标志物CA50,CA125,CA242,CA19-9及CEA对肝门胆管癌诊断的意义。方法:选择近2年间住院且术后病理证实为肝门胆管癌患者90例作为观察组,同期胆道良性病变患者91例作为对照组,采用全自动电化学发光分析仪测定两组患者术前血清中CA50,CA125,CA242,CA19-9及CEA的水平。分别计算两组血清中5种肿瘤标志物的敏感性、特异性及准确性。结果:观察组血清CA50,CA242,CA19-9及CEA的水平明显高于对照组(均P<0.01),而观察组血清CA125水平与对照组血清CA125水平比较无统计学差异(P>0.05)。血清CAl9-9在肝门胆管癌中阳性率最高(86.67%),次为CA242(63.33%)及CA50(60%);两组患者血清中5种标志物的阳性率比较,除CA125外,各相应组间差异具有统计学意义(P<0.05)。对于肝门胆管癌的诊断,血清CA19-9灵敏度最好(93.98%),而CEA的特异度最好(94.60%)。结论:联合检测CA50,CA242,CA19-9和CEA有助于肝门胆管癌与胆道良性疾病鉴别。

Objective： To determine the diagnostic value of the combination detection of the tumor markers, CA50, CA125, CA242, CA19-9 and CEA for hilar cholangiocarcinoma. Methods： Ninety patients admitted to our hospital in the recent two years, who were confirmed having hilar cholangiocarcinoma by postoperative pathology, were included in the observation group, and another group of 91 patients with benign biliary tract diseases hospitalized during the same period served as control group.The serum levels of CA.50, CA125, CA242, CA19-9 and CEA of the two groups were detected by automatic electrochemiluminescence analyzer, and the sensitivities, specificities and accuracies of the five tumor markers of the two groups were determined, respectively. Results： The serum levels of CA50, CA242, CA19-9 and CEA in the observation group were all significantly higher than those of the control group, （all P〈0.01）, but the difference of the serum levels of CA125 between the two groups had no statistical significance （P〉0.05）. In hilar cholangiocarcinoma, the serum CA19-9showed the highest positive rate （86.67%） among the five markers, followed by CA242 （63.33%）, and CA.50 （60%）, successively. Between the two groups, the positive rates of the five tumor markers, except for CA125, had significant differences （all P〈0.05）. For the diagnosis ofhilar cholangiocarcinoma, serum CA19-9 had thebest sensitivity （93.98%）, while CEA had the best specificity （94.60%）. Conclusion： Combination detection of CAS0, CA242, CA19-9 and CEA is helpful for differential diagnosis ofhilar cholangiocarcinoma and benign biliary tract diseases.