CA199联合ERCP对胰胆管恶性肿瘤的诊断价值研究

目的研究CA19—9对胆道和胰腺恶性肿瘤的诊断价值,以及胆总管梗阻对CA19—9值的影响。方法首先回顾性分析168例胆道和胰腺疾病的患者血清CA199对胆道和胰腺恶性肿瘤的诊断价值。然后前瞻性地对54例因胆总管梗阻而行ERCP＋胆总管支架植入术的患者进行研究。结果胆道和胰腺恶性肿瘤组CA199水平明显高于良性疾病组,差异具有统计学意义（P〈0.01）。血清CA199对胰腺和胆道恶性肿瘤诊断的敏感性分别为100%和84%,特异性分别为87.27%和53.16%。在ERCP术前CA199对胆总管恶性梗阻的诊断的特异性只有43.48%,而在ERCP术后上升到86.96%。结论 CA199对胰腺和胆道恶性肿瘤具有较高的诊断价值,尤其是解除胆道梗阻以后其诊断恶性肿瘤的特异性显著升高。

The Study about Diagnostic Value of CA199 Combined with ERCP to Pancreaticobiliary Malignant Tumors

Objective： To study the diagnostic value of CA199 to malignant tumors of pancreaticobiliary and the influence of common bile duct obstruction to CA19-9 levels. Method： First of all, we collected 168 cases of clinical data of patients with biliary and pancreatic diseases, and retrospectively analyzed the diagnostic value of serum CA199 in patients with biliary and pancreatic malignancies. Then, we carried out a prospective study including 54 cases of patients with common bile duct obstruction. In this project, we studied the influence of ERCP and common bile duct stent implantation to CA199 levels and analyzed the diagnostic value of CA199 combined with ERCP to malignant obstruction of bile duct. Result： The retrospective data showed that CA199 levels ofbiliary and pancreatic malignant tumor group were significantly higher than those of benign disease group （P 〈0.01） , the sensitivity of CA19-9 to malignant tumors of pancreas and biliary were 84% and 100% and the specificity 87.27% and 53.16% respectively. The prospective data showed that specificity of CA199 to bile duct malignant obstruction was only 43.48% before the ERCP and common bile duct stent implantation and the specificity rised to 86.96% after the operation. Conclusion： CA199 has a high diagnostic value to pancreatic and biliary tract malignancies, especially to biliary obstruction after the ERCP and common bile duct stent implantation operation.