多种肿瘤标志物在胰腺癌临床分期中的应用  

The application of serum tumor markers for pancreatic cancer in clinical stage assessment and preoperative evaluation

作　　者：齐晓光[1] 李栋[2] 王立夫[1] 任峰[3] 孙罡[1] 林晓琳[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化内科,上海200025 [2]上海市徐汇区中心医院消化科 [3]上海交通大学医学院附属瑞金医院普外科

出　　处：《胃肠病学和肝病学杂志》2009年第8期692-694,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：国家自然科学基金(30672385);上海市科委浦江人才计划A类项目(05PJ14058)

摘　　要：目的探讨多种肿瘤标志物检测对胰腺癌的临床分期及术前评估的应用。方法45例胰腺癌,其中Ⅰ-Ⅱ期16例、Ⅲ期11例、Ⅳ期18例,检测其术前CA199、CA125、CEA等肿瘤指标,分析多种肿瘤标志物在胰腺癌临床分期及术前评估中的意义。结果不同分期胰腺癌之间CA199水平差异无显著性(P=0.381),CA125、CEA的水平随着分期的递增而升高,但统计分析显示只有CA125组间差异有统计学意义(P<0.05)。按照是否可切除分为两组,CA199水平在两组间差异无统计学意义(Z=1.045,P=0.296),而CA125、CEA水平在两组间存在显著性差异(P=0.000、0.045)。多因素分析结果显示,胰腺癌的不同分期与有无黄疸、胆道疾病史、性别、体重减轻等之间存在显著统计学差异(P<0.05),而与术前胆红素水平、血糖、糖尿病史、年龄等之间无统计学差异。结论CA125和CEA可辅助用于胰腺癌患者临床分期及术前评估,具有无创性、病人依从性好等优点,具有较好的临床潜在应用价值。Objective To evaluate serum tumor markers in the assessment of TNM stage in pancreatic cancer. Methods Pre-operative serum was collected in 45 pancreatic cancer patients. All diagnosis was confirmed by post-operation histological or intraoperative cytological biopsy examination. According to the fifth edition of TNM classification, there were 16 stage Ⅰ -Ⅱ patients, Ⅱ stage Ⅲ patients and 18 stage Ⅳ patients. Serum CA19-9, CEA and CA125 were measured using chemiluminescent microparticle immunoassay （CMIA）. Results The serum levels of CEA and CA125 in patients with stage m or Ⅳ patients were significantly higher than that of stage Ⅰ - Ⅱ patients （P 〈 0.05）. Higher levels of serum markers were associated with advanced stage of the disease or unresectability of pancreatic cancer （P 〈 0.05）. In addition, muhivariates analysis showed that advanced stages of pancreatic cancer correlated with jaundice, bile duct diseases history, gender and weight loss （P 〈 0.05）. However, with respect to serum levels of bilirubin, blood sugar, history of diabetes and age, there was no significantly difference in different TNM stages. Conclusion CA125 and CEA may be valuable markers for the clinical evaluation of advanced metastatic pancreatic cancer.

关 键 词：胰腺肿瘤 TNM分期 术前评估 肿瘤标志物 

分 类 号：R735.9[医药卫生—肿瘤]