胆管癌患者血清、胆汁中的CA19—9水平ROC曲线分析及临床参考价值评估

Diagnostic and optimum reference value of serum and bile CA19-9 in cholangiocarcinoma

目的探讨血清、胆汁CA19—9水平对胆管癌的早期诊断和鉴别诊断的价值。方法对82例胆道恶性病变患者和85例胆道良性疾病者测定血清和胆汁的CA19—9水平，进行对比分析和评价。结果恶性组患者血清、胆汁CA19—9水平均明显高于良性组患者（P〈0．001）；胆汁CA19-9诊断胆管癌的ROC曲线下面积为0．764，诊断价值高于血清的0．701；根据诊断评价指标，胆汁CA19—9灵敏度、特异度、符合率、阳性预测值和阴性预测值（57．90％、95．50％、77．25％、92．30％、70．43％）均高于血液CA19—9（50．90％，89．10％，70．66％，82．35％，65．62％），两项联合检测灵敏度、符合率及阴性预测值均有不同程度提高。结论选择血清、胆汁CA19-9进行联合检测，在胆管癌的早期筛检中具有重要参考价值。

Objective To evaluate the value of the levels of CA19-9 in the serum and bile for diag-nosis of diseases of billiary system. Methods Concentration of serum and bile CA19-9 was determined in 82 patients with cbolangiocarcinoma and 85 patients with benign disease, and the results were being analyzed and evaluated by statistics. Results The level of serum and bile CA19-9 in diseases of cholangiocarcinoma was higher than benign disease （P 〈 0. 001 ） , and the diagnostic value of bile CA19-9 was higher than serum CA19-9 with ROC. In accordance with evaluation indicators, the sensitivity, specificity, coincidence rate, positive predictive rate and negative predictive rate of bile CA19-9 were all higher than serum. And the sen-sitivity, coincidence rate and negative predictive rate were enhanced after combined measurement of serum and bile CA19-9. Conclusion The way of combined measurement of serum and bile CA19-9 is an important reference in early screening cholangiocarcinoma.