CAJ | 학술논문

目的评价肿瘤标志物CA19-9、CA242、CEA单独或联合检测在肝胆管结石合并胆管癌诊断与预后评估中的作用.方法对100例确诊的肝胆管结石合并胆管癌(异常胆管组)患者,手术前检测血清CA19-9、CA242、CEA值,并检测70例肝胆管结石合并胆管炎患者和30例肝血管瘤(正常胆管组)患者的血清CA19-9、CA242、CEA水平.结果单独应用于异常胆管组诊断时,CA199的灵敏度最高,但是其特异性显著低于CA242和CEA (P＜0.01).三项肿瘤标志物中,两项以上高于正常值的患者其生存期显著低于仅有一项高于正常值或三项皆正常的患者(P＜0.05).结论 CA19-9在异常胆管组诊断率方面优于CEA和CA242,联合检测可以提高诊断的特异性；肿瘤标志物高水平与肝胆管结石合并胆管癌进展期相关；三项肿瘤标志物中两项或三项高于正常值的患者其生存期较短.
목적 평개종류표지물CA19-9、CA242、CEA단독혹연합검측재간담관결석합병담관암진단여예후평고중적작용.방법 대100례학진적간담관결석합병담관암(이상담관조)환자,수술전검측혈청CA19-9、CA242、CEA치,병검측70례간담관결석합병담관염환자화30례간혈관류(정상담관조)환자적혈청CA19-9、CA242、CEA수평.결과 단독응용우이상담관조진단시,CA199적령민도최고,단시기특이성현저저우CA242화CEA (P＜0.01).삼항종류표지물중,량항이상고우정상치적환자기생존기현저저우부유일항고우정상치혹삼항개정상적환자(P＜0.05).결론 CA19-9재이상담관조진단솔방면우우CEA화CA242,연합검측가이제고진단적특이성；종류표지물고수평여간담관결석합병담관암진전기상관；삼항종류표지물중량항혹삼항고우정상치적환자기생존기교단.
Objective To study the values of serum CA19-9,CA242,CEA,alone or in combination in the diagnosis and prognosis of combined hepatobiliary calculus and cholangiocarcinoma (HCWC).Method Serum CA19-9,CA242,CEA in 100 patients with HCWC,70 patients with hepatobiliary calculus combined with cholangitis and 30 patients with hepatic hemangioma (normal bile duct group) were preoperatively studied.Results When the serum levels of CA19-9,CA242,CEA were separately used in the diagnosis of HCWC,the sensitivity of CA19 9 was highest,but its specificity was significantly lower than that of CA242 and CEA (P＜0.01).Patients with all the three tumor markers raised had significantly lower survival than those of patients with only one or two raised markers (P＜0.05).Conclusions The diagnostic rate for CA19 9 in HCWC was better than that of CEA and CA242.A joint detection improved the diagnostic specificity.Raised tumor markers were associated with progression of HCWC.Survival was worse in patients with 3 raised markers than those with 2 or 1 raised markers.