血清肿瘤标志物联合检测在胰腺癌诊治中的意义

Significance of combined testing of serum tumor markers in the diagnosis and treatment of pancreatic adenocarcinoma

目的 研究血清肿瘤标志物联合检测在胰腺癌诊治中的作用。方法 采用化学发光免疫法、荧光免疫法和放射免疫法对 12 9例胰腺癌患者的血清肿瘤标志物AFP、CEA、CA - 5 0、CA72 - 4、CA - 12 5、CA15 3、CA19- 9和CA2 4 2水平进行测定 ,并与 99例非胰腺恶性肿瘤及 6 3例良性疾病患者进行对比 ,分析其临床诊断价值。 2 7例胰腺癌根治术后还接受了连续监测。结果 8种肿瘤标志物中 ,CA19 9、CA2 4 2、CA - 5 0和CA72 - 4对胰腺癌诊断有较高价值 ;平行法联合检测可使诊断的敏感性提高至 89 2 % ,系列法联合检测则使特异性提高至 92 3%。术后监测表明 ,胰腺癌手术切除后血清肿瘤标志物水平下降。结论 CA19- 9、CA2 4 2、CA - 5 0和CA72 - 4水平对胰腺癌的诊断和随访具有临床价值 。

Objective To evaluate the value of combined testing of serum tumor markers in the diagnosis and prognosis of pancreatic adenocarcinoma.Methods Eight serum tumor markers, including AFP\,CEA\,CA-50\,CA72-4\,CA-125\,CA153\,CA19-9 and CA242, was tested in 129 patients with pancreatic adenocarcinoma by using chemiluminescence immunoassay, immunofluorescence assay and immunoradiometric assay, respectively; 99 patients with other malignant tumors, 63 patients with begnign disease and 27 cases following pancreatectomy were studied at the same time.Results Among the 8 tumor markers, CA19-9\,CA242\,CA-50 and CA72-4 were more valuable in the diagnosis of pancreatic carcinoma. Method of parallel combined testing could increase the diagnostic sensitivity to 89.2% and serial combined examination could increase the diagnostic specificity to 92.3%. The serum tumor markers was decreased significantly after radical tumor resection.Conclusion Serum CA19-9\,CA242\,CA-50 and CA72-4 were the preferred tumor markers to be used in the diagnosis and the follow up of operated cases of pancreatic carcinoma. Combined testing could increase the sensitivity and specificity in the diagnosing pancreatic carcinoma.