中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2014年
9期
662-666
,共5页
汤小龙%张建伟%陈应泰%兰忠民%王成锋
湯小龍%張建偉%陳應泰%蘭忠民%王成鋒
탕소룡%장건위%진응태%란충민%왕성봉
胆管肿瘤%糖类抗原19-9%癌胚抗原%临床病理因素
膽管腫瘤%糖類抗原19-9%癌胚抗原%臨床病理因素
담관종류%당류항원19-9%암배항원%림상병리인소
Cholangiocarcinoma,extrahepatic%CA19-9%CEA%Clinicopathological features
目的 探讨肝外胆管癌(ECC)患者术前血清糖类抗原19-9(CA19-9)和癌胚抗原(CEA)的水平与患者临床病理特征的关系.方法 对中国医学科学院肿瘤医院收治的126例ECC患者进行回顾性分析,研究各临床病理特征与CA19-9和CEA阳性率及平均值的关系.结果 126例ECC患者术前血清CA19-9的均值为595.3 U/ml,其中91例患者的CA19-9水平高于正常值,CA19-9诊断ECC的敏感性为72.2％;CEA的均值为12.6 U/ml,其中26例患者的CEA水平高于正常值,CEA诊断ECC的敏感性为20.6％.联合检测术前血清CA19-9和CEA的水平,共有97例患者高于正常值,联合检测诊断ECC的敏感性为77.0％.CA19-9诊断ECC的敏感性与各临床病理因素无关(P＞0.05);CEA诊断ECC的敏感性与肿瘤位置有关(P＜0.05),对下段ECC的诊断敏感性较差.年龄＞60岁、肿瘤侵犯神经的ECC患者,CA19-9均值较高;肿瘤位于胆管中段的ECC患者,CEA均值较高(P＜0.05).对于术前行减黄治疗的ECC患者,其减黄前后的血清CA19-9差异无统计学意义(P＞0.05).结论 CA19-9诊断ECC的敏感性不受患者性别、年龄、血型、肿瘤部位、分化程度、肿瘤大小、T分期、有无脉管瘤栓、有无淋巴结转移、有无神经侵犯以及术前黄疸程度等因素的影响;而CEA对ECC的诊断敏感性受肿瘤部位的影响,对下段ECC的诊断敏感性较差.CA19-9的均值与ECC的局部侵犯有关,年龄＞ 60岁的患者CA19-9的均值较高.
目的 探討肝外膽管癌(ECC)患者術前血清糖類抗原19-9(CA19-9)和癌胚抗原(CEA)的水平與患者臨床病理特徵的關繫.方法 對中國醫學科學院腫瘤醫院收治的126例ECC患者進行迴顧性分析,研究各臨床病理特徵與CA19-9和CEA暘性率及平均值的關繫.結果 126例ECC患者術前血清CA19-9的均值為595.3 U/ml,其中91例患者的CA19-9水平高于正常值,CA19-9診斷ECC的敏感性為72.2％;CEA的均值為12.6 U/ml,其中26例患者的CEA水平高于正常值,CEA診斷ECC的敏感性為20.6％.聯閤檢測術前血清CA19-9和CEA的水平,共有97例患者高于正常值,聯閤檢測診斷ECC的敏感性為77.0％.CA19-9診斷ECC的敏感性與各臨床病理因素無關(P＞0.05);CEA診斷ECC的敏感性與腫瘤位置有關(P＜0.05),對下段ECC的診斷敏感性較差.年齡＞60歲、腫瘤侵犯神經的ECC患者,CA19-9均值較高;腫瘤位于膽管中段的ECC患者,CEA均值較高(P＜0.05).對于術前行減黃治療的ECC患者,其減黃前後的血清CA19-9差異無統計學意義(P＞0.05).結論 CA19-9診斷ECC的敏感性不受患者性彆、年齡、血型、腫瘤部位、分化程度、腫瘤大小、T分期、有無脈管瘤栓、有無淋巴結轉移、有無神經侵犯以及術前黃疸程度等因素的影響;而CEA對ECC的診斷敏感性受腫瘤部位的影響,對下段ECC的診斷敏感性較差.CA19-9的均值與ECC的跼部侵犯有關,年齡＞ 60歲的患者CA19-9的均值較高.
목적 탐토간외담관암(ECC)환자술전혈청당류항원19-9(CA19-9)화암배항원(CEA)적수평여환자림상병리특정적관계.방법 대중국의학과학원종류의원수치적126례ECC환자진행회고성분석,연구각림상병리특정여CA19-9화CEA양성솔급평균치적관계.결과 126례ECC환자술전혈청CA19-9적균치위595.3 U/ml,기중91례환자적CA19-9수평고우정상치,CA19-9진단ECC적민감성위72.2％;CEA적균치위12.6 U/ml,기중26례환자적CEA수평고우정상치,CEA진단ECC적민감성위20.6％.연합검측술전혈청CA19-9화CEA적수평,공유97례환자고우정상치,연합검측진단ECC적민감성위77.0％.CA19-9진단ECC적민감성여각림상병리인소무관(P＞0.05);CEA진단ECC적민감성여종류위치유관(P＜0.05),대하단ECC적진단민감성교차.년령＞60세、종류침범신경적ECC환자,CA19-9균치교고;종류위우담관중단적ECC환자,CEA균치교고(P＜0.05).대우술전행감황치료적ECC환자,기감황전후적혈청CA19-9차이무통계학의의(P＞0.05).결론 CA19-9진단ECC적민감성불수환자성별、년령、혈형、종류부위、분화정도、종류대소、T분기、유무맥관류전、유무림파결전이、유무신경침범이급술전황달정도등인소적영향;이CEA대ECC적진단민감성수종류부위적영향,대하단ECC적진단민감성교차.CA19-9적균치여ECC적국부침범유관,년령＞ 60세적환자CA19-9적균치교고.
Objective To study the correlation between clinicopathological features and serum carbohydrate antigen 19-9 (CA19-9)/ carcinoembryonic antigen (CEA) in patients with extrahepatic cholangiocarcinoma (ECC).Methods The clinicopathological data of 126 cases of extrahepatic cholangiocarcinoma treated in our department from Jan.1999 to Dec.2012 were collected and analyzed in this study.The correlation between clinicopathological features and sensitivity of CA19-9/CEA was analyzed by chi-square test.The correlation of clinicopathological features and value of serum CA19-9/CEA was analyzed by t test and F test.Results The average value of CA19-9 before surgery in the 126 patients was 595.3 U/ml.The values of CA19-9 in 91 patients were abnormal and the sensitivity of CA19-9 was 72.2％.The average value of CEA before surgery was 12.6 U/ml.The value of CEA in 26 patients were abnormal and the sensitivity of CEA was 20.6％.The values of combined detection of serum CA19-9 and CEA before surgery were abnormal in a total of 97 cases with a sensitivity of 77.0％.There was no significant correlation between clinicopathological features and sensitivity of CA19-9 (P ＞ 0.05).The location of tumor was significantly correlated to the diagnostic sensitivity of CEA.The sensitivity of CEA to distal ECC was only 15.4％.The value of CA19-9 was relatively high in patients ＞ 60-year old or with neural invasion,while CEA was higher when tumor was located in the middle of bile duct (P ＜ 0.05).There was no significant difference of serum CA19-9 before and after jaundice reduction (P ＞ 0.05).Conclusions The diagnostic sensitivity of CA19-9 is not affected by gender,age,blood type,tumor location,degree of differentiation,tumor size,T stage,vascular tumor thrombus,lymph node metastasis,perineural invasion,and preoperative jaundice.However,the diagnostic sensitivity of CEA is affected by tumor location.The value of CA19-9 is correlated with tumor invasion and is relatively high in patients above 60 years old.
