CA19-9对胰腺癌诊断价值探讨

CA19-9's diagnostic value to pancreatic cancer

目的分析各种因素特别是CA19—9对胰腺新生物性质的诊断意义。方法回顾性分析昆明医学院附属昆华医院118例因胰腺占位接受胰腺根治性部分切除术的病人(包括恶性59例和良性59例)的术前CA19—9水平及年龄和有无黄疸等因素,使用Logistic回归分析以上变量。结果重要的恶性预测指标包括CA19—9升高、年龄大于50岁及术前黄疸单独的CA19—9升高的敏感性和特异性分别为71%和83%,而年龄联合黄疸因素的预测准确率(敏感性和特异性分别为76%和92%)高于CA19—9。老年黄疸病人CA19—9升高或单独的CA19—9〉150kU/L对胰腺癌有很高的特异性。结论年龄联合黄疸因素比单独的CA19—9升高对胰腺癌的预测价值要高CA19—9升高必须综合考虑其他临床因素才能有效判断胰腺占位的性质。CA19—9〉150kU/L预测价值较高。

Objective To reviewed patients who underwenl pancreatectomy lo determine factors predictive of malignancy with particular attention to the CA19-9.Methods 118 patients underwenl pancreatectomy for malignant(n=59) or benign(n=59) pancreatic lesions.Include preoperative CA19-9 level,age and preoperative jaundice.Logistic regression analysis was used to determine multivariate predictor of malignancy.Results Significant multivariate were increased CA19-9,age older than 50 years and preoperative jaundice The sensitivity and specificity of increased CA19-9 alone were 71%and 83%,respectively.The combination of age older than 50 years and jaundice was more accurate predictor than CAI9-9(sensitivity,76%;specificity,92%).Increased CA19-9 was highly specific(97%) for malignancy in older jaundiced patients or when the preoperative level was greater than 150kU/L.Conclusion Age and preoperative jaundice are more predictive of malignancy than CA19-9 alone unless levels are greater than 150kU/L Preoperative CA19-9 levels should he interpreted within the context of these other clinical factors.