与临床表现不符血清CA19-9异常升高1例及原因分析.docVIP

与临床表现不符血清CA19-9异常升高1例及原因分析 　　【摘要】 糖抗原(carbohydrate antigen, CA) 19-9是一种同结直肠癌细胞株免疫小鼠所获抗体结合的抗原。肿瘤标志物(tumor marker)是反映肿瘤存在的化学类物质。它们不存在于正常成人组织而仅见于胚胎组织，或在肿瘤组织中的含量大大超过在正常组织里的含量，它们的存在或量变可以提示肿瘤的性质，借以了解肿瘤的组织发生、细胞分化、细胞功能，以帮助肿瘤的诊断、分类、预后判断以及治疗指导。在胰腺癌，胆囊癌，胆管癌患者血清中CA19-9显著升高，因此在临床上作为胆胰系统肿瘤的标志物被广为使用。但是亦有因服用胃黏膜保护剂或胆胰炎性反应等导致CA19-9假阳性的报道。本文1例与临床表现严重不符的血清CA19-9升高的病例，在此做一报道，并对假阳性的原因作了分析。 　　【关键词】 CA19-9；异常升高 　　 　　Inconsistent with the clinical manifestations of abnormal increase of seram CA19-9 and cause analysis 1 case 　　ZHANG Wen,WANG Huai-lian.Dalian City Maternity Hospital,Liaoning 116021,China 　　【Abstract】 Objective Carbohydrate antigen (CA) 19-9 is a kind of antigen which link to antibody aquired by mouse immunized with colon and rectal cancer cell strains. Tumor marker is a kind of chemical matter reflect tumor existence. They dont exist normal adult tissue but embryonal tissue either, or their contents in tumor tissue exceed nomal tissue extremely. Their exsistence or quantitative change maybe present tumor quality to realize occurrence of tumor tissue, cells differentiation, and cells function, which can help the diagnosis , classification, prognosis and therapic instruction of tumor. Level of CA19-9 rises in patients serum of pancreatic cancer, gallbladder cancer and cholangiocarcinoma, so it is used widely as marker of pancreatic and gallbladder system clinically. Nevertheless, it was reported that taking mucosal protective agent or pancreatic and gallbladder inflammation and so on could induce false positive of CA19-9. The author find out a case of CA19-9 level’s rise which doest accord with clinical represention extremely, report as follows and analyse the reason of false positive. 　　【Key words】 CA19-9；Rise abnormally 　　 　　1 临床资料 　　 　　患者女，52岁，丙型肝炎病毒阳性，因血清中CA19-9异常升高而被疑???胰腺癌。其他肿瘤标志物检测值均在正常范围，腹部超声，CT等影像学检查均未见明显肿瘤。 　　 　　2 CA19-9的检测 　　 　　采用化学发光酶免疫测定法(chemiluminescent enzyme immunoassay, CLEIA)，固相为鼠抗人CA19-9抗体结合微粒，标记抗体为碱性磷酸酶标记的鼠抗人CA19-9抗体。正常值在37IU/ml以下。 　　 　　3