CA19-9、CEA联合检测在消化系统恶性肿瘤中的诊断应用

Application of Combined efection of CA19-9 and CEA in the Diagnosis of Malignant Tumor in Digestive System

目的：评价血清和腹水中CA19-9、CEA含量变化对消化系统恶性肿瘤的诊断价值。方法：CA19-9采用免疫放射法（RIMA）、CEA采用放射免疫法（RIA），检测192例消化系统恶性肿瘤手术前、后及126例正常人血清CA19-9、CEA的含量；并观察20例癌性腹水及28例良性腹水CA19-9、CEA的含量与变化。且对血清CA19-9、CEA单项与联检阳性率进行比较。结果：所测各种恶性肿瘤病人血清CA19-9、CEA的含量均显著高于正常对照组（P＜0.01），手术后患者血清CA19-9、CEA的水平显著低于手术前（P＜0.01）；术前、术后比较阳性率有显著性差异（P＜0.01），且联检较单检阳性率有明显提高（P＜0.05）；癌性腹水患者血清、腹水中CA19-9、CEA水平明显高于良性腹水患者（P＜0.01）。结论：联合检测血清和腹水中CA19-9、CEA在消化系统恶性肿瘤的辅助诊断、疗效观察及良恶性腹水的鉴别中均有一定的临床应用价值。

Objective: To assess the value of levels of CA19-9 and CEA in serum and ascites in the diagnosis of malignant tumor in digestive system. Methods: The levels of CA19-9 and CEA in serum were detected by RIMA and RIA, respectively, in healthy adults ( n =126) and in patients with malignant tumor of digestive system ( n =192) before and after operation. The difference of levels of CA19-9 and CEA between the patients with malignant ascites ( n =20) and benign ascites ( n =28) was observed. The positive rate of CA19-9, CEA, combined CA19-9 and CEA in serum were compared. Results: The levels of CA19-9 and CEA in serum in patients with malignant tumor of digestive system were higher than those in the healthy group ( P ＜0.01), and were significantly decreased after operation ( P ＜0.01). The positive rate of combined CA19-9 and CEA was significantly higher than that of individual CA19-9 or CEA ( P ＜0.05). The levels of CA19-9 and CEA in serum and ascites were higher in patients with malignant ascites than in patients with benign ascites ( P ＜0.01). Conclusions: Combined detection of levels of CA19-9 and CEA in serum and ascites might be useful in diagnosis of malignant tumor of digestive system, in observation of the therapy effect and in identification of tumor.