血清CA19-9、CEA、CA125联合检测对胰腺癌同期放化疗患者诊断及预后的临床意义  

Clinical value of serum CA19-9,CEA and CA125 in diagnosis and prognosis of unresectable pancreatic cancer patients treated with chemoradiotherapy

作　　者：穆晓峰[1] 曹京旭[1] 王迎选[1] 俞利权[1] 宁健[1] 吴芳[2] 宋薇[1] 李韧[1] 付淑云[1] 

机构地区：[1]中国人民武装警察部队总医院肿瘤中心,北京100039 [2]中国人民武装警察部队总医院中心药房,北京100039

出　　处：《临床荟萃》2011年第2期113-116,共4页Clinical Focus

摘　　要：目的明确检测血清癌抗原19-9(cancer antigen 19-9,CA19-9)、癌胚抗原(carcinoembryonic antigen,CEA)、癌抗原125(cancer antigen 125,CA125)在胰腺癌诊断及治疗过程中的作用及意义。方法采用回顾性分析的方法,对本院24例同步放化疗胰腺癌患者血清CA19-9、CEA及CA125进行相关比较,以明确联合检测对胰腺癌诊断的敏感度、治疗前血清标记物水平与临床分期及预后的关系、治疗前后血清肿瘤标记物变化程度与临床疗效及预后的关系。结果在胰腺癌诊断方面,CA19-9敏感度最高可达87.5%,若联合检测敏感度可达95.8%;治疗前各血清标记物水平与临床分期无关;治疗前CA19-9≥200 kU/L、CEA≥10μg/L、CA125≥50 kU/L者中位生存期明显短于CA19-9<200 kU/L、CEA<10μg/L、CA125<50 kU/L者,分别为8.0(1.4)个月vs 15.0(3.7)个月,6.0(1.8)个月vs12.0(1.7)个月,6.0(1.6)个月vs 12.0(5.6)个月(P<0.05或<0.01);而治疗前后任何异常血清标记物下降≥50%,其总缓解率为43.0%,疾病控制率为100%,中位生存期为12.0(3.2)个月。结论 CA19-9、CEA及CA125联合检测可提高胰腺癌诊断的敏感度,动态观察标记物的变化对判断疗效及预后有一定意义。Objective To evaluate the value of single or combined cancer antigen 19-9（CA19-9）,carcinoembryonic antigen（CEA） and cancer antigen 125（CA125） measurement in diagnosis and prognosis of unresectable pancreatic cancer treated with chemoradiotherapy.Methods We retrospectively reviewed the data from 24 patients with unresectable pancreatic cancer between 2004 and 2009.CA 19-9,CEA and CA125 levels （pre-,post-treatment） and their decline were analyzed for diagnosis,radiologic response and overall survival.Results In pancreatic cancer diagnosis,the sensitivity of CA19-9 was the highest in three tumor markers,up to 87.5%.Combined detection of CA19-9,CEA and CA125 improved the diagnostic sensitivity,up to 95.8%.No difference in pre-treatment can be seen in CA19-9 or CEA or CA125 level with the tumor stage.According to the levels of pre-treatment,the median survival spans of CA19-9≥200 kU/L,CEA≥10 μg/L,CA125≥50 kU/L,were significantly shorter than those of CA19-9200 kU/L,CEA10 μg/L,CA12550 kU/L respectively,8.0（1.4） months vs 15.0（3.7） months,6.0（1.8） months vs 12.0（1.7） months,6.0（1.6） months vs 12.0（5.6） months（P〈0.05 or 0.01）.If post-treatment tumor markers,CA19-9 or CA125 or CEA,declined≥50%,the overall response rate would be 43.0%,disease control rate 100%,and median survival span 12.0（3.2） months.Conclusion Combined detection of CA19-9,CEA and CA125 can improve the diagnostic sensitivity.Dynamic observation of changes in CA19-9,CEA and CA125 can determine the efficacy and prognosis of unresectable pancreatic cancer receiving chemoradiotherapy.

关 键 词：胰腺肿瘤 癌胚抗原 诊断 鉴别 放射疗法 药物疗法 

分 类 号：R576[医药卫生—消化系统]