肿瘤标记物联合检测对胰腺癌的诊断价值.DOCVIP

临床医学论文-肿瘤标记物联合检测对胰腺癌的诊断价值 【摘要】? 目的 探讨糖类抗原CA199、CA242及CEA联合检测对胰腺癌患者的临床诊断价值。方法 用放射免疫分析法检测胰腺癌病人55例、良性胰腺疾病49例、正常对照61例的CA199、CA242及CEA血清水平。结果 胰腺癌患者血清CA199、CA242及CEA值均明显高于正常组及良性胰腺疾病组，两者比较有显著性差异 (P0.05);CA199、CA242及CEA联合检测较单测任何一项其灵敏度、特异度均有提高，分别达到87.3%和 89.1%。 结论 胰腺癌肿瘤标志物CA199、CA242及CEA可作为早期诊断胰腺癌的工具，联检CA199、CA242及CEA能提高对胰腺癌的诊断和鉴别诊断效率。 【关键词】? CA199; CA242; CEA; 胰腺癌 　　ABSTRACT：Objective To investigate the clinical value of combined test of serum CA199,CA242 and CEA levels in the diagnosis of patients with pancreatic cancer.Methods Serum levels of CA199,CA242 and CEA in 55 cases of pancreatic cancer patients, 49 cases of benign pancreatic lesion patients and 61 normal controls were detected by radioimmunoassay.Results Serum CA199 ,CA242 and CEA levels in pancreatic cancer patients were significantly higher than those in normal controls and benign pancreatic lesion patients (P0.05). If serum CA199 ,CA242 and CEA were detected simultaneously, the sensitivity and specificity of diagnosis of pancreatic cancer could be improved, and reached 87.3% and 89.1% respectively.Conclusion The changes of serum CA199,CA242 and CEA levels are helpful in the diagnose of pancreatic cancer.The combined detection of serum CA199, CA242 and CEA could improve the sensitivity and specificity in diagonosis and differential diagnosis of pancreatic cancer. 　　KEY WORDS： CA199; CA242; CEA; Pancreatic cancer 　　胰腺癌是预后较差的消化系统肿瘤，近年来其发病率和病死率呈上升趋势。其5年生存率仅为3%左右，临床上90%以上的患者确诊时已属中晚期，确诊后平均生存时间一般不超过6个月。胰腺癌能否根治、治疗后复发及病死率的高低与最初确诊时的分期密切相关[1]。为了观察肿瘤标志物对胰腺癌的诊断价值，我们对胰腺癌患者血清中CA199、CA242及癌胚抗原(CEA)进行联合检测，报道如下。 　　1 资料与方法 　　1.1 一般资料 　　胰腺癌组: 2003年3月至2008年3月在我院住院的患者, 经影像学检查、手术探查或手术病理明确诊断为胰腺癌者55例, 男32例, 女23例; 年龄28~78 岁。良性胰腺疾病组：同期住院良性胰腺病患者49例, 男26例, 女23例; 年龄23~76 岁。正常对照组61例，男31例, 女30例，年龄21~75岁，均为本院体检合格的正常人, 无心、肝、肺、肾等重要脏器疾患。 　　1.2 方法 　　采用放免分析法测定血清中各指标含量。CA类放免盒由中国肿瘤研究所佳科公司提供，CEA放免药盒由中国同位素公司北方研究所提供，仪器为美国DPC公司的 γ12计数器，严格按说明书操作。正常参考值：CA19937u/ml, CA242正常值20u/ml, CEA10ng/ml。 　　1.3 统计学处理 　　结果以均数±标准差(±s)表示, 统计学处理用方差分析,P0.05为差异有显著性意义。 　　2