中国实验诊断学
中國實驗診斷學
중국실험진단학
CHINESE JOURNAL OF LABORATORY DIAGNOSIS
2014年
4期
568-571
,共4页
AFP%CEA%CA19-9%CA72-4%胆管癌%胰管癌
AFP%CEA%CA19-9%CA72-4%膽管癌%胰管癌
AFP%CEA%CA19-9%CA72-4%담관암%이관암
AFP%CEA%CA19-9%CA72-4%Cholangiocarcinoma%Carcinoma,Pancreatic Ductal
目的：探讨胆汁及血清甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原19-9（CA19-9）及糖类抗原72-4（CA72-4）对胆胰恶性疾病的诊断价值。方法测定34例胆胰良性疾病及6例胆胰恶性疾病的胆汁及血清 AFP、CEA、CA19-9及 CA72-4的含量，通过统计学分析获得有诊断价值的肿瘤标志物，同时建立一种联合预测的诊断算法，分别绘制其受试者工作特征（ROC）曲线，并进行分析，比较它们的诊断价值。结果良性组胆汁 CA72-4（1．50 U/ml）比恶性组胆汁 CA72-4（8．65 U/ml）低（P ＝0．019）；良性组血清 CA19-9（20．24 U/ml）比恶性组血清 CA19-9（266.24 U/ml）低（P ＝0．049）；胆汁 CA72-4、血清 CA19-9及联合预测诊断胆胰恶性疾病的敏感性分别为80．0％、80.0％及100．0％，特异性分别为81．0％、76．2％及66．7％。联合预测的 ROC 曲线下面积（0．867）高于胆汁 CA72-4（0．771）及血清CA19-9（0．790）。结论胆汁 CA72-4及血清 CA19-9对诊断胆胰恶性疾病有参考价值，综合胆汁 CA72-4及血清CA19-9的联合预测对诊断胆胰恶性疾病有更大的参考价值。
目的：探討膽汁及血清甲胎蛋白（AFP）、癌胚抗原（CEA）、糖類抗原19-9（CA19-9）及糖類抗原72-4（CA72-4）對膽胰噁性疾病的診斷價值。方法測定34例膽胰良性疾病及6例膽胰噁性疾病的膽汁及血清 AFP、CEA、CA19-9及 CA72-4的含量，通過統計學分析穫得有診斷價值的腫瘤標誌物，同時建立一種聯閤預測的診斷算法，分彆繪製其受試者工作特徵（ROC）麯線，併進行分析，比較它們的診斷價值。結果良性組膽汁 CA72-4（1．50 U/ml）比噁性組膽汁 CA72-4（8．65 U/ml）低（P ＝0．019）；良性組血清 CA19-9（20．24 U/ml）比噁性組血清 CA19-9（266.24 U/ml）低（P ＝0．049）；膽汁 CA72-4、血清 CA19-9及聯閤預測診斷膽胰噁性疾病的敏感性分彆為80．0％、80.0％及100．0％，特異性分彆為81．0％、76．2％及66．7％。聯閤預測的 ROC 麯線下麵積（0．867）高于膽汁 CA72-4（0．771）及血清CA19-9（0．790）。結論膽汁 CA72-4及血清 CA19-9對診斷膽胰噁性疾病有參攷價值，綜閤膽汁 CA72-4及血清CA19-9的聯閤預測對診斷膽胰噁性疾病有更大的參攷價值。
목적：탐토담즙급혈청갑태단백（AFP）、암배항원（CEA）、당류항원19-9（CA19-9）급당류항원72-4（CA72-4）대담이악성질병적진단개치。방법측정34례담이량성질병급6례담이악성질병적담즙급혈청 AFP、CEA、CA19-9급 CA72-4적함량，통과통계학분석획득유진단개치적종류표지물，동시건립일충연합예측적진단산법，분별회제기수시자공작특정（ROC）곡선，병진행분석，비교타문적진단개치。결과량성조담즙 CA72-4（1．50 U/ml）비악성조담즙 CA72-4（8．65 U/ml）저（P ＝0．019）；량성조혈청 CA19-9（20．24 U/ml）비악성조혈청 CA19-9（266.24 U/ml）저（P ＝0．049）；담즙 CA72-4、혈청 CA19-9급연합예측진단담이악성질병적민감성분별위80．0％、80.0％급100．0％，특이성분별위81．0％、76．2％급66．7％。연합예측적 ROC 곡선하면적（0．867）고우담즙 CA72-4（0．771）급혈청CA19-9（0．790）。결론담즙 CA72-4급혈청 CA19-9대진단담이악성질병유삼고개치，종합담즙 CA72-4급혈청CA19-9적연합예측대진단담이악성질병유경대적삼고개치。
Objective To investigate the diagnostic value of the concentrations of bile and serum alpha-fetoprotein (AFP),carcinoembryonic antigen (CEA),carbohydrate antigen 19-9 (CA19-9)and carbohydrate antigen 72-4 (CA72-4)for distinguishing malignant from benign pancreatobiliary diseases.Methods The bile and serum concentrations of AFP,CEA,CA19-9 and CA72-4 were measured from 34 patients with benign and 6 with malignant pancreatobiliary dis-eases.The tumor markers which are of diagnostic value are obtained by statistical analysis and a diagnostic algorithm was established with predicted probability.Then the receiver-operating characteristic (ROC)curves are drawn,respec-tively,to analyze and compare their diagnostic value.Results Benign bile CA72-4 (1.50 U/ml)was lower than malig-nant (8.65 U/ml)(P =0.019);Benign serum CA19-9 (20.24 U/ml)was lower than malignant (266.24 U/ml)(P =0.049);The sensitivity and specificity of bile CA72-4,serum CA19-9 and predicted probability were 80.0%,80.0%and 100.0%,and 81.0%,76.2% and 66.7% for diagnosing malignant pancreatobiliary diseases,respectively.In the di-agnostic algorithm each marker provided independent diagnostic information and the probability of malignant pancreato-biliary diseases was calculated.It was applied as a diagnostic algorithm providing higher value than the markers alone.In ROC curve analysis the area under the curve of predicted probability was 0.867 higher than the area of bile CA72-4 (0.771)or serum CA19-9 (0.790).Conclusion Bile CA72-4 and serum CA19-9 provide additive diagnostic information in malignant pancreatobiliary diseases and the use of the diagnostic algorithm established by predicted probability im-proves diagnostic value.
