CEA、CA50、CA19-9和CA125联合检测在肿瘤性梗阻性黄疸诊断中的意义  

The diagnostic significance of the combined detection of serum CEA,CA50,CA19-9 and CA125 in patients with obstructive jaundice from tumors

作　　者：陈圣开[1] 何世举[1] 

机构地区：[1]重庆市第三人民医院肝胆外科,重庆400014

出　　处：《重庆医科大学学报》2011年第7期842-845,共4页Journal of Chongqing Medical University

摘　　要：目的:探讨肿瘤标志物CEA、CA50、CA19-9和CA125联合检测在肿瘤性梗阻性黄疸诊断中的意义。方法:分析我科2004年1月-2011年1月151例梗阻性黄疸患者的有关临床资料。资料分为肿瘤组(74例)和良性疾病组(77例)。结果:CEA和CA125检测值在肿瘤组明显高于良性疾病组(P<0.05)。CEA、CA50、CA19-9和CA125在肿瘤组的敏感性分别为:27.40%、62.86%、59.46%和21.43%,与良性疾病组比较差异无统计学意义(P>0.05)。CEA大于参考值上限2倍的敏感性在肿瘤组明显高于良性疾病组,分别为13.70%和2.60%(P<0.05)。CEA、CA50、CA19-9 3项联合检测同时2项以上异常的敏感性在肿瘤组明显高于良性疾病组,分别为57.97%和40.54%(P<0.05),特异性59.46%,准确性58.74%,阳性预测值57.14%,阳性似然比1.43。CEA、CA50、CA19-9和CA125 4项联合检测同时3项以上异常的敏感性在肿瘤组明显高于良性疾病组,分别为34.14%和5.88%(P<0.05),特异性94.12%,准确性61.33%,阳性预测值87.5%,阳性似然比5.81。CEA、CA50、CA19-9和CA125的ROC曲线A值分别为:0.597、0.575、0.573和0.646。结论:CEA、CA50、CA19-9和CA125对肿瘤性梗阻性黄疸诊断价值较低。CEA大于参考值上限2倍以上或CEA、CA50和CA19-9 3项联合检测出现2项以上异常或CEA、CA50、CA19-9和CA125 4项联合检测出现3项以上异常提示肿瘤可能性大。且在特异性、阳性预测值和阳性似然比方面,以上"4项"联合检测出现3项以上异常优于以上"3项"联合检测出现2项以上异常。Objective：To explore the diagnostic significance of combined detection of serum CEA,CA50,CA19-9 and CA125 in patients with obstructive jaundice from tumors.Methods：The clinical data of 151 patients with obstructive jaundice from January 2004 to January 2011 were analyzed.The clinical data were divided into tumors group（74 cases）and non-tumors group（77 cases）.Results：The level of CEA and CA125 was higher in tumors group than in non-tumors group（P0.05）.The sensitivities of CEA、CA50、CA19-9 and CA125 in tumors group were 27.40%,62.86%,59.46% and 21.43% respectively,which were not higher than in non-tumors group（P0.05）.The sensitivity of CEA above double normal level was higher in tumors group than in non-tumors group（P0.05）.The sensitivity of two or more abnormalities in the combined detection of CEA,CA50 and CA19-9 was higher in tumors group than in non-tumors group（P0.05）.The sensitivity was 57.97% and 40.54% respectively.The specificity,accuracy,positive predictive value（PPV）and positive likelihood ratio（LR＋）was 59.46%,58.74%,57.14% and 1.43 respectively.The sensitivity of three or more abnormalities in the combined detection of serum CEA,CA50,CA19-9 and CA125 was higher in tumors group than in non-tumors group（P0.05）.The sensitivity was 34.14% and 5.88% respectively.The specificity,accuracy,PPV and LR＋ was 94.12%,61.33%,87.5% and 5.81 respectively.The aera under the ROC curves of CEA,CA50,CA19-9 and CA125 was 0.597,0.575,0.573 and 0.646 respectively.Conclusion：The diagnostic value of CEA,CA50,CA19-9 and CA125 in patients with obstructive jaundice from tumors is not obvious.CEA above double normal level,two or more abnormalities in the combined detection of CEA,CA50 and CA19-9 or three or more abnormalities in the combined detection of the four markers improve the probability of tumor.The specificity,PPV and LR＋ of three or more abnormalities in the combined detection of CEA,CA50,CA19-9 and CA125 is higher than the ones of two or more abnormalities in the combi

关 键 词：肿瘤标志物 CEA CA50 CA19-9 CA125 梗阻性黄疸 诊断 

分 类 号：R604[医药卫生—外科学]