CAJ | 학술논문

目的研究超声内镜联合检测血清糖链抗原CA19-9、CA242水平对胰腺癌早期诊断的临床应用价值.方法采用超声内镜探查102例高危人群胰腺的整体情况,同时采用酶链免疫吸附实验法检测血清CA19-9和CA242水平.结果 9.80%(10/102)的病人血清CA19-9异常,12.75%(13/102)的病人CA242异常,二者均异常者7例,其中3例行EUS检查明确胰腺癌诊断,1例临床诊断胰腺癌,1例腹膜后占位,2例正常.102例入选者同时行超声内镜检查,2例显示胰头部不规则低回声区,2例显示胰腺囊实性肿物,3例诊断为胰腺癌,并得到手术病理证实.血清CA19-9诊断正确百分率为90.20%(92/102),灵敏度为50%(4/8),特异度为93.62%(88/94);血清CA242诊断正确百分率为87.25%(89/102),灵敏度为50%(4/8),特异度为90.43%(85/94);EUS联合CA19-9、CA242诊断胰腺癌正确百分率为98.04%(100/102),灵敏度为100%(8/8),特异度为97.87%(92/94).EUS联合CA19-9、CA242诊断胰腺癌的正确百分率显著高于CA242(P＜0.01),明显高于CA19-9诊断的正确百分率(P＜0.05).结论超声内镜联合检测血清糖链抗原CA19-9、CA242对胰腺癌早期筛查具有较高的价值.
목적 연구초성내경연합검측혈청당련항원CA19-9、CA242수평대이선암조기진단적림상응용개치.방법 채용초성내경탐사102례고위인군이선적정체정황,동시채용매련면역흡부실험법검측혈청CA19-9화CA242수평.결과 9.80%(10/102)적병인혈청CA19-9이상,12.75%(13/102)적병인CA242이상,이자균이상자7례,기중3례행EUS검사명학이선암진단,1례림상진단이선암,1례복막후점위,2례정상.102례입선자동시행초성내경검사,2례현시이두부불규칙저회성구,2례현시이선낭실성종물,3례진단위이선암,병득도수술병리증실.혈청CA19-9진단정학백분솔위90.20%(92/102),령민도위50%(4/8),특이도위93.62%(88/94);혈청CA242진단정학백분솔위87.25%(89/102),령민도위50%(4/8),특이도위90.43%(85/94);EUS연합CA19-9、CA242진단이선암정학백분솔위98.04%(100/102),령민도위100%(8/8),특이도위97.87%(92/94).EUS연합CA19-9、CA242진단이선암적정학백분솔현저고우CA242(P＜0.01),명현고우CA19-9진단적정학백분솔(P＜0.05).결론 초성내경연합검측혈청당련항원CA19-9、CA242대이선암조기사사구유교고적개치.
Objective To determine the clinical value of EUS in combination with detection of CA19-9 and CA242 for early diagnosis of pancreatic cancer.Methods General features of high-risk group were determed by EUS and the plasma levels of CA19-9 and CA242 measured by ELISA.Results The serum level of CA19-9 was abnormal in 9.80% (10/102) and that of CA242 in 12.75% (13/102) of the patients.They were both abnormal in 7 cases.Of the 7 cases, 3 were found to suffer from pancreatic cancer by EUS, 1 had the tumor that had been clinically confirmed, 1 had posterior peritoneal tumor and 2 were normal.Among 102 cases detected by EUS, 2 showed low echo in pan-creatic head, 2 semi-cyst, 3 pancreatic cancer and proved by pathology.Accurate diagnotic rate, sensi-tivity and specificity were 90.20% (92/102), 50% (4/8) and 93.62% (88/94), respectively, for serum CA19-9.For the serum CA242, the 3 parameters were 87.25% (89/102), 50% (4/8) and 90.43% (85/94), respectively.For combination of both methods, they were 98.04% (100/102), 100%(8/8) and 97.87%(92/94), respectively.Accurate diagnostic rate of the latter was significantly higher than that of the former 2(P＜0.05).Concision Combination of EUS with detection of serum CA19-9 and CA242 is of great vlaue for early screening of pancreatic cancer.