血清胆汁CA19-9、CEA、CA242联合检测诊断胆道良恶性肿瘤的可行性分析

Clinical value of serum bile CA19-9,CEA,CA242 detection in benign and malignant biliary tumor

目的:探讨血清、胆汁CA19-9、CEA、CA242联合诊断胆道良恶性肿瘤的临床价值。方法:对象为2013年10月-2015年2月来我院诊治的疑似恶性胆道肿瘤的患者202例,均行手术探查。所有患者均通过穿刺的方式取胆汁进行CA19-9、CEA、CA242检测,比较不同疾病类型患者血清、胆汁中的CA19-9、CEA、CA242检测水平,分析血清胆汁联合检测在胆道良恶性肿瘤中的诊断价值。结果:202例手术探查患者中,98例经病理证实为恶性胆道肿瘤患者、22例为良性胆道肿瘤患者,82例为其他胆道疾病。恶性胆道肿瘤与良性胆道肿瘤患者胆汁中CA242、CA19-9和CEA的表达水平要显著性的高于在血清中的表达水平(P<0.05);恶性肿瘤组患者的胆汁中CA242、CA19-9和CEA检测水平均显著性高于良性肿瘤患者(P<0.05);胆汁CA242、CA19-9和CEA联合诊断胆道恶性肿瘤的敏感率为33.66%,准确率为88.98%,特异性为91.16%,阳性率为35.24%。结论:利用胆汁中肿瘤标记物对胆道肿瘤的检测水平要高于血清中的水平,采用CA19-9、CEA、CA242的联合检测是诊断胆道肿瘤比较理想的组合。上述肿瘤标志物的组合能够提高胆道肿瘤良恶性的预判准确度,对于早期胆道良恶性肿瘤的发现、治疗具有十分重要的意义。

Objective：To investigate the value of serum, bile CA19 -9, CEA, CA242 in benign and malignant bili- ary tumor. Methods ： All 202 patients were taken bile puncture and tested for CA19 - 9, CEA, CA242, Results： Of 202 cases of surgical exploration patients ,98 patients with pathologically proven malignant biliary cancer,22 cases of be- nign biliary cancer,82 cases of other biliary tract disease. Malignant bile duct cancer and patients with benign bile duct cancer bile in CA242, CA19 -9 and CEA expression level was significantly higher than in the serum levels（ P 〈 0.05 ）. Patients with malignant bile CA242, CA19 -9 and CEA levels were significantly higher in patients with benign tumors（P 〈 0.05 ）. Bile CA242, CA19 -9 and CEA in diagnosis of biliary cancer sensitivity was 33.66% , accuracy was 88.98% ,specificity 91.16% ,the positive rate was 35.24%. Conclusion： Bile levels of tumor markers for bile duct cancer are higher than levels in serum,using CA19 - 9,combined detection of CEA, CA242 diagnosis of bile duct cancer is an ideal combination.