CA19-9、CEA、CA242联合检测对胆管癌诊断的评估价值

Values of CA19-9,CEA and CA242 Combined Detection in Evaluation of Diagnosis for Bile Duct Carcinoma

目的探讨血清糖类抗原199(CA19-9)、糖类抗原242(CA242)及癌胚抗原(CEA)联合检测对胆管癌的临床诊断价值。方法选取2012年1月—2015年10月收治的胆管癌52例作为观察组,选取同期住院良性胆道疾病52例为对照组。采用放射免疫测定血清CA19-9、CA242及CEA浓度及其阳性率,并计算3种肿瘤标志物的灵敏度、特异度、阳性似然比、阴性似然比及联合肿瘤标志物检测的准确度。结果观察组CEA、CA19-9、CA242浓度明显高于对照组(P<0.01)。观察组阳性率明显高于对照组(P<0.01)。单一肿瘤标志物检测时CA19-9的灵敏度最高,CA242的特异度最高。4种组合检测中CA19-9+CEA+CA242灵敏度最高,CA19-9+CA242特异度和准确度最高。结论血清CA19-9、CEA和CA242联合检测可提高诊断胆管癌的水平,明显提高胆管癌检出率、降低漏诊率,对早期诊断、治疗具有较高的临床指导价值。

Objective To investigate clinical value of serum carbohydrate antigen 19-9（ CA199）,carbohydrate antigen 242（ CA242） and carcinoembryonic antigen（ CEA） combined detection in diagnosis of bile duct carcinoma.Methods A total of 52 patients with bile duct carcinoma admitted during January 2012 and October 2015 were selected as observation group,and 52 patients with benign biliary tract diseases admitted at same period were selected as control group. Serum concentrations of CA199,CA242 and CEA and their positive rates were detected using radiation immunoassay,and values of sensitivity,specificity and positive and negative likelihood ratios and accuracy of combination tumor marker detection of CA199,CA242 and CEA were calculated. Results In observation group,CEA and CA19-9 and CA242 concentrations were significantly higher（ P〈0. 01）,and their positive rates were significantly higher than those in control group（ P〈0. 01）. Single tumor marker detection showed that CA19-9 sensitivity was the strongest,and CA242 specificity was the highest. Combination tumor marker detection showed that CA19-9 ＋ CEA ＋ CA242 had the strongest sensitivity,and CA19-9 ＋ CA242 had the highest in specificity and accuracy. Conclusion Combined detection of CA19-9,CEA and CA242 can significantly improve diagnostic level and detection rate,and decrease missed diagnosis rate of bile duct carcinoma.