血清颗粒蛋白前体、CEA、AFP、CA19-9鉴别胆管良恶性病变的价值  

Value of serum PGRN、CEA、AFP、CA19-9 in differentiating cholangiocarcinoma from benign biliary tract disease

作　　者：刘渊[1] 王正廷[1] 龚彪[1] 王伟[1] 周郁芬[1] 别里克[1] 许斌[1] 刘磊[1] 蒋唯松[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

出　　处：《诊断学理论与实践》2012年第5期451-454,共4页Journal of Diagnostics Concepts & Practice

摘　　要：目的:探讨血清颗粒蛋白前体(progranulin,PGRN)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、甲胎蛋白(AFP)检测在鉴别胆管良恶性病变中的价值。方法:检测31例术后病理证实的胆管癌患者、30例胆管良性病变患者及10名健康人的血清PGRN、CA19-9、CEA、AFP。结果:血清PGRN、CA19-9、CEA水平在胆管癌患者、胆管良性病变患者及正常人中依次降低(P<0.01)。胆管癌患者及胆管良性病变患者的血清AFP较正常人均明显升高(P<0.01),但胆管癌与胆管良性病变患者间的差异则无统计学意义(P>0.05)。PGRN鉴别胆管良恶性病变的灵敏度最高(83.87%),而CA19-9的特异度最高(100%)。联合检测采用并联试验可进一步提高诊断的灵敏度和诊断效能。结论:PGRN有作为胆管肿瘤标志物的潜力,与CA19-9、CEA、AFP联合检测可有较高的诊断价值。Objective To determine the value of serum PGRN, CA19-9, CEA and AFP in discriminating cholangio carcinoma from benign biliary tract disease. Methods Thirty-one cholangiocarcinoma,30 benign biliary tract disease and 10 healthy controls were enrolled in this study. Serum levels of PGRN, CA19-9,CEA and AFP were measured. Results Serum PGRN, CA19-9 and CEA levels decreased in the order of cholangiocarcinoma,benign biliary tract disease and healthy controls （P〈0.01）.Serum AFP level in cholangiocarcinoma and benign biliary tract disease was higher than healthy controls （P〈0.01）,but no significant difference was found between cholangiocarcinoma and benign biliary tract disease（P〉 0.05）. Diagnostic sensitivity of PGRN was the highest among the four tumor markers for distinguishing benign from malig nant lesion in bile duct, CA19-9 had the highest specificity. Combined use of these tests could increase diagnostic sensi tivity and improve the diagnostic efficacy.Conclusions Serum PGRN is a potential marker for discriminating cholangiocar cinoma from benign biliary tract disease, and the combined detection of PGRN,CA19-9,CEA and AFP can enhance the di agnostic efficacy.

关 键 词：颗粒蛋白前体 糖类抗原19—9 癌胚抗原 甲胎球蛋白 胆管癌 

分 类 号：R735.8[医药卫生—肿瘤]