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1、膽管癌患者血清CEA、CA19-9.CA242聯(lián)合檢測臨床意義［摘要］目的：探討膽管癌患者血清CEA、CA19-9.CA242的檢測對其診斷的臨床應用價值。方法：采用化學發(fā)光免疫法及放射免疫分析法對148例膽管癌患者血清CEA、CA19-9.CA242進行檢測。結(jié)果：CEA、CA19-9、CA242敏感性分別為52.70%,82.43%,63.51%,聯(lián)合檢測敏感性為89.89%,較單獨檢測明顯提高。CA19-9在術(shù)后2周明顯下降，對判斷膽管癌的預后可能有重要意義。結(jié)論：三種標志物聯(lián)合檢測可明顯提高膽管癌的檢出率，降低漏檢率；CA19-9在監(jiān)測膽管癌
2、術(shù)后復發(fā)中可能具有較大的臨床價值。［關(guān)鍵詞］膽管癌;CEA；CA19-9；CA242［中圖分類號］R446［文獻標識碼］B［文章編號］1673-7210(2008)07(a)-096-02StudyofrelationshipbetweencholangiocarcinomawithCEA,CA19-9andCA242inbileandbloodCHENJin-longl,YIShi-jianl,HEDe2,ZHONGDe~wu3,ZHAOZhen-weil,XIANGHua-guol(1.DepartmentofSurgery,FuyongHosp
3、ital,Shenzhen518103,China；2.DepartmentofGeneralSurgery,Bao-anPeople'sHospital,Shenzhen518101,China；3.ThesecondXiangyaHospital,CentralSouthUniversity,Changsha410008,China)[Abstract]Objective：ToinvestigatetheclinicalvalueofCEA,CAI9~9andCA242inthediagnosisofcholangiocarcinomapatie
4、nts.Methods：CEA,CA19-9,CA242in148casesweredetectedinChemiluminescentimmunoassayandradioimmunoassay?ResuIts：ThesensitivityratesofusingsinglepositivediagnosticindicatorofCEA,CAI9-9,CA242tocho1angiocarcinomawere52.70%,82.43%and63.51%,respectively,incombineddetectionforthreetumorma
5、rkers,thesensitivityratesincreasedto89.89%,obviouslyhigherthaninsingledelection.CAI9-9decreasedsharplytwoweekslaterafteroperation,itindicatedthatCA19-9wasanimportantmarkeronprognosisofcholangiocarcinoma?Conelusion：Incombineddetectionforthethreetumormarkerswouldobviouslyincrease
6、cholangiocarcinomadiagnosisratesanddecreasemisseddiagnosisrates?ItmighthaveanimportantclinicalvalueofCAI9*9onmonitoringpostoperativerecurrentcholangiocarcinonia?[Keywords]Cholangiocarcinoma；CEA；CA19-9；CA242膽管癌惡性程度髙、預后差。實現(xiàn)對膽管癌的早期診斷以及根據(jù)其預后情況開展有效的綜合治療是提高膽管癌患者生存率的重要手段。檢測血清腫瘤標志物是一種有
7、效的無創(chuàng)檢查方法，聯(lián)合檢測兩種以上腫瘤標志物可以彌補單個腫瘤標志物的某些局限性，提高診斷的敏感性和特異性。癌胚抗原(carcinoembryonicantigen,CEA),癌抗原19-9(cancerantigen19-9,CAI9-9)和癌抗原242(cancerantigen242.CA242)是三個重要的與膽管癌相關(guān)的血清學標志物。本研究目的是同時檢測膽管癌患者血清中CEA,CA19-9和CA242,探討這三種腫瘤標志物單獨和聯(lián)合檢測在膽管癌診斷中的臨床意義。1資料與方法1.1臨床資料選取2003年3月?2007年12月深圳市寶安區(qū)福永醫(yī)院、
8、深圳市寶安區(qū)人民醫(yī)院及中南大學湘雅二醫(yī)院收治的膽管癌患者148例。男78例，女70例，年齡31?78歲，中位
