全科医学临床与教育
全科醫學臨床與教育
전과의학림상여교육
CLINICAL EDUCATION OF GENERAL PRACTICE
2013年
6期
634-636,639
,共4页
童小英%童亚琴%李寅苏%黄宣
童小英%童亞琴%李寅囌%黃宣
동소영%동아금%리인소%황선
糖类抗原199%胰腺癌%无症状人群
糖類抗原199%胰腺癌%無癥狀人群
당류항원199%이선암%무증상인군
CA199%pancreatic cancer%asymptomatic individuals
目的：评估血清糖类抗原199（CA199）在健康体检者中筛选胰腺癌以及其他恶性疾病的临床价值。方法选择6780例健康体检者，检测血清CA199，进行胸片、腹部超声、胃镜、结肠镜检查，分析CA199在检出胰腺癌与其他恶性肿瘤的灵敏度、特异度、阳性预测值。结果有585例患者（8.63％）的CA199≥37 U/ml。5例通过B超被诊断为胰腺癌，诊断出其他癌症的70个患者中的27位患者的CA199≥37 U/ml。 CA199正常值设定在≥37 U/ml，其诊断胰腺癌与其他恶性肿瘤的灵敏度为80.00％与32.86％，特异度为91.42％与91.62％，然而其阳性预测率仅为0.68％与3.93％。若CA199设定在＞80 U/ml，其诊断胰腺癌与其他恶性肿瘤的灵敏度为20.00％与10.00％，特异度为99.37％与99.43％，其阳性预测率为4.44％与15.55％。结论单纯依靠血清CA199作为体检人群恶性肿瘤的初筛工具不理想，需联合多种肿瘤标志物检测可以提高恶性肿瘤的诊断价值。在临床工作中，可以结合必要的影像学检查对血清CA199增高人群进行评估。
目的：評估血清糖類抗原199（CA199）在健康體檢者中篩選胰腺癌以及其他噁性疾病的臨床價值。方法選擇6780例健康體檢者，檢測血清CA199，進行胸片、腹部超聲、胃鏡、結腸鏡檢查，分析CA199在檢齣胰腺癌與其他噁性腫瘤的靈敏度、特異度、暘性預測值。結果有585例患者（8.63％）的CA199≥37 U/ml。5例通過B超被診斷為胰腺癌，診斷齣其他癌癥的70箇患者中的27位患者的CA199≥37 U/ml。 CA199正常值設定在≥37 U/ml，其診斷胰腺癌與其他噁性腫瘤的靈敏度為80.00％與32.86％，特異度為91.42％與91.62％，然而其暘性預測率僅為0.68％與3.93％。若CA199設定在＞80 U/ml，其診斷胰腺癌與其他噁性腫瘤的靈敏度為20.00％與10.00％，特異度為99.37％與99.43％，其暘性預測率為4.44％與15.55％。結論單純依靠血清CA199作為體檢人群噁性腫瘤的初篩工具不理想，需聯閤多種腫瘤標誌物檢測可以提高噁性腫瘤的診斷價值。在臨床工作中，可以結閤必要的影像學檢查對血清CA199增高人群進行評估。
목적：평고혈청당류항원199（CA199）재건강체검자중사선이선암이급기타악성질병적림상개치。방법선택6780례건강체검자，검측혈청CA199，진행흉편、복부초성、위경、결장경검사，분석CA199재검출이선암여기타악성종류적령민도、특이도、양성예측치。결과유585례환자（8.63％）적CA199≥37 U/ml。5례통과B초피진단위이선암，진단출기타암증적70개환자중적27위환자적CA199≥37 U/ml。 CA199정상치설정재≥37 U/ml，기진단이선암여기타악성종류적령민도위80.00％여32.86％，특이도위91.42％여91.62％，연이기양성예측솔부위0.68％여3.93％。약CA199설정재＞80 U/ml，기진단이선암여기타악성종류적령민도위20.00％여10.00％，특이도위99.37％여99.43％，기양성예측솔위4.44％여15.55％。결론단순의고혈청CA199작위체검인군악성종류적초사공구불이상，수연합다충종류표지물검측가이제고악성종류적진단개치。재림상공작중，가이결합필요적영상학검사대혈청CA199증고인군진행평고。
Objective To assess the significance of serum CA 199 to predict malignant diseases in healthy population. Methods The serum CA 199, chest film, abdominal ultrasonography and endoscopy of 6 780 healthy people were exam-ed or detected and the sensitivity, specificity and positive rate of pancreatic cancer and other malignant diseases were ana-lyzed. Results A total of 585 individuals (8.63%) with CA 199 were higher than 37 U/ml. Five patients were diagnosed with pancreatic cancer.27 in 70 patients' CA 199 levels with other cancer were higher than 37U/ml. If the cut-off value of CA 199 was set as 37U/ml, the sensitivity for diagnosing pancreatic cancer and other cancer were 80.00% and 32.86%, and the specificity were 91.42% and 91.62%, respectively. However, the positive predictive rates for pancreatic cancer and other cancers were 0.68% and 3.93%.If the cut-off value of CA 199 was set as 80U/ml, the sensitivity for diagnosing pancreatic cancer and other cancer were 20.00%and 10.00%, and the specificity were 99.37% and 99.43%, respectively. The positive predictive rates for pancreatic cancer and other cancers were 4.44%and 15.55%. Conclusion Efficacy of CA 199 in predicting either pancreatic cancer or other cancers in asymptomatic individuals is low. It will be helpful for in-creasing diagnosis rate of malignant tumors to combine serial tumor markers. In clinic, imaging examinations can be com-bined to evaluate higher serum levels of CA199 people.
