肿瘤标志物CA19-9、CA242、CA125在胰腺癌诊断和预后评估中的价值  

The Value of Serum CA19-9,CA242 and CA125 in the Diagnosis and Prognosis of Pancreatic Cancer

作　　者：毛奇琦[1] 严惟力[2] 孙旭[1] 胡尧[3] 钟良[1] 

机构地区：[1]复旦大学附属华山医院消化科 [2]上海交通大学医学院附属仁济医院核医学科 [3]复旦大学附属华山医院检验科,上海200040

出　　处：《标记免疫分析与临床》2009年第2期79-82,共4页Labeled Immunoassays and Clinical Medicine

基　　金：国家自然科学基金项目(30770599);中国博士后科学基金(2005038143)

摘　　要：为了评价CA19-9、CA242、CA125单独或联合检测在胰腺癌诊断和预后评估中的作用,对105例确诊的胰腺癌患者,手术前检测血清CA19-9、CA242、CA125值,并检测了70例非胰腺恶性肿瘤患者和30例良性胰腺疾病患者的血清CA19-9、CA242、CA125水平。结果发现,单独应用于胰腺癌诊断时,CA19-9的灵敏度最高,但是其特异性显著低于CA242和CA125(P<0.01)。联合检测CA125和CA242可使诊断特异性达到92%。CA242高于正常值的胰腺癌患者,其生存期明显短于CA242值正常的胰腺癌患者(P<0.05)。三项肿瘤标志物中两项以上高于正常值的患者,其生存期显著低于仅有一项高于正常值或三项皆正常的患者(P<0.05)。CA19-9在胰腺癌诊断率方面优于CA125和CA242。联合使用CA125和CA242可以提高诊断的特异性。肿瘤标志物高水平与胰腺癌进展期相关。三项肿瘤标志物中两项或三项高于正常值的患者其生存期较短。To evaluate the value of single or combined CA19-9, CA242 and CA125 measurement in the diagnosis and prognosis of pancreatic cancer,the serum levels of CA19-9, CA242 and CA125 in 105 pre-operative pancreatic cancers patients, 70 non-pancreatic malignancies and 30 benign pancreatic diseases were measured. The results showed that the sensitivity of CA19-9 alone was the highest in the pancreatic cancers, but the specificity of CA19-9 was significantly lower than that of CA242 and CA125 （P 〈 0.01 ）. The combination of CA242 and CA125 could increase the specificity to 92%. In the pancreatic cancers with positive CA242 expression, the survival time was remarkably shorter than that of negative CA242 patients（ P 〈0.05 ）. The survival time in the pancreatic cancers with more than two positive expressions of three tumor markers was significantly shorter than that of patients with only one or no marker positive expression （ P 〈 0.05 ）. These results indicated that the diagnostic rate of CA19-9 in the pancreatic cancer was better than that of CA242 and CA19-9. The combination of CA242 and CA125 test can improve the diagnostic specificity. High levels of serum markers are associated with advanced stage of the disease. Patients with two or three positive markers of CA19-9, CA242 and CA125 simultaneously have shorter survival time.

关 键 词：胰腺 胰腺癌 肿瘤标志物 CA19-9 CA242 CA125 

分 类 号：R735.9[医药卫生—肿瘤]