血清肿瘤标记物联合检测在胰腺癌诊治中的作用

Role of combined Testing of Serum Tumor Markers in the Diagnosis and Treatment of Pancreatic Adenocarcinoma.

目的：观察胰腺癌患者血清肿瘤标记物的表达，分析血清肿瘤标记物联合检测在胰腺癌诊治中的作用。方法：采用荧光免疫分析法和放射免疫法检测９５例胰腺癌患者的８种血清ＡＦＰ、ＣＥＡ、ＣＡ５０、ＣＡ１５－３、ＣＡ１９－９、ＣＡ７２－４、ＣＡ１２５和ＣＡ２４２肿瘤标记物的表达，并与其他７０例恶性肿瘤患者和７３例良性疾病患者作对照，分析其临床诊断价值。对２５例胰腺癌手术切除患者进行术后肿瘤标记物的连续监测。结果：８种肿瘤标记物中ＣＡ１９－９、ＣＡ２４２、ＣＡ５０和ＣＡ１２５对胰腺癌诊断有较高价值；平行法联合检测可使诊断的灵敏度提高至９０．２％，系列法联合检测可使特异度提高至９３．５％。介入治疗对肿瘤标记物的表达影响不明显，手术切除肿瘤后，肿瘤标记物的水平显著下降。结论：血清ＣＡ１９－９、ＣＡ２４２、ＣＡ５０和ＣＡ１２５的检测对胰腺癌的诊断和随访是有临床价值的，联合检测可以增加诊断的特异度和灵敏度。

To assess the value of combined testing of serum tumor markers in the diagnosis and treatment of pancreatic carcinoma. Methods: Detection of 8 serum tumor markers, including AFP, CEA, CA50, CA15-3, CA 19-9, CA72-4, CA125 and CA242, was carried out in 95 patients with pancreatic carcinoma by auto time-resolved fluorometric assay(ATRFMA) and immunoradiometric assay(IRMA); 70 patients with other malignant tumors, 73 patients with benign disease and 25 patients following pancreatectomy were studied at the same time. Results: Among the 8 tumor markers, CA19-9, CA242, CA50 and CA125 were more valuable in the diagnosis of pancreatic carcinoma. Method of parallel combined testing could increase the diagnostic sensitivity to 90.2%, and serial combined examination could increase the diagnostic specificity to 93.5%. The expression of tumor markers did not undergo any obvious change after intervention chemotherapy, but decreased significantly after radical tu- mor resection. Conclusions: Serum CA199, CA242, CA50 and CA125 were the preferred tumor markers to be used in the diagnosis and the follow-up of operated cases of pancreatic carcinoma. Combined testing could in- crease the sensitivity and specificity in diagnosing pancreatic carcinoma.