血清糖类抗原19-9、癌胚抗原在胆管癌诊断中的应用价值

The application value of serum carbohydrate antigen 19-9 and carcinoembryonic antigen in the diagnosis of cholangiocarcinoma

目的探讨检测血清糖类抗原19-9(CA19-9)、癌胚抗原(CEA)在胆管癌诊断中的应用价值。方法选择2014年3月至2016年11月我院收治的74例胆管癌患者作为胆管癌组,60例胆道结石患者作为良性疾病组,60例体检健康者作为健康对照组,检测3组患者血清的CEA、CA19-9水平。结果胆管癌组患者血清CA19-9及CEA水平均明显高于良性疾病组和健康对照组,差异有统计学意义(P<0.05);良性疾病组患者血清CA19-9及CEA水平明显高于健康对照组,差异有统计学意义(P<0.05)。Ⅲ-Ⅳ期胆管癌组患者血清CA19-9及CEA水平明显高于Ⅰ-Ⅱ期胆管癌组,差异有统计学意义(P<0.05)。ROC曲线分析显示,血清CA19-9的曲线下面积为0.807(95%CI为0.662-0.952),最佳临界值为114.32 U/mL,诊断敏感性为63.6%,特异性为91.7%;血清CEA的曲线下面积为0.873(95%CI为0.753-0.994),最佳临界值为2.55ng/mL,诊断敏感性为77.3%,特异性为75.0%。结论胆管癌患者血清CEA以及CA19-9水平明显的升高,对于该病的诊断具有十分重要的临床意义,且可以提高肿瘤与炎症的鉴别诊断,为选择更加合理的治疗方案提供依据。

Objective To investigate the application value of serum carbohydrate antigen 19-9and carcinoembryonic antigen in the diagnosis of cholangiocarcinoma.Methods 74 patients with cholangiocarcinoma in our hospital from March 2014 to November 2016 were choosed as cholangiocarcinoma group,60 patients with cholelithiasis as benign disease group,60 healthy subjects as healthy control group,The serum levels of CEA,CA19-9were detected.Results The serum levels of CA19-9and CEA in patients with cholangiocarcinoma were significantly higher than those in benign disease group and healthy control group,the difference was statistically significant（P〈0.05）.The levels of CA19-9and CEA in benign disease group were significantly higher than those in healthy control group,the difference was statistically significant（P〈0.05）.The serum levels of CA19-9and CEA in stage Ⅲ to IV cholangiocarcinoma group were significantly higher in stage Ⅰto Ⅱ cholangiocarcinoma,the difference was statistically significant（P〈0.05）.ROC curve analysis showed that the area under the curve of serum CA19-9was 0.807（95%CI 0.662-0.952）,the optimal critical value was 114.32U/mL,the diagnostic sensitivity was 63.6%,specificity was 91.7%;the area under the curve of serum CEA was 0.873（95%CI 0.753-0.994）,the optimal critical value was 2.55ng/mL,the diagnostic sensitivity was 77.3%,specificity was 75.0%.Conclusion The serum levels of CA19-9and CEA in patients with cholangiocarcinoma increase significantly,which has very important significance for the diagnosis of patients with cholangiocarcinoma,and greatly improve the differential diagnosis of tumor and inflammation.It can provide the basis for the selection of more reasonable treatment plan.