CA19-9、CA242及CEA联合检测在良恶性梗阻性黄疸鉴别诊断中的应用

褚亮; 万圣云; 周少波; 刘会春; 高涌

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CA19-9、CA242及CEA联合检测在良恶性梗阻性黄疸鉴别诊断中的应用

褚亮 , 万圣云 , 周少波 , 刘会春 , 高涌

文章导航 > 蚌埠医学院学报 > 2011, 36 > 10: (1084-1086)

引用本文:

Citation:

CA19-9、CA242及CEA联合检测在良恶性梗阻性黄疸鉴别诊断中的应用

1. 安徽医科大学第二附属医院普外科, 安徽合肥, 230000;
2. 蚌埠医学院第二附属医院普外科, 安徽蚌埠 233040;
3. 蚌埠医学院第一附属医院肝胆外科, 安徽蚌埠 233004;
4. 蚌埠医学院第一附属医院血管外科, 安徽蚌埠 233004

作者简介: 褚亮(1981-),男,硕士研究生,主治医师.

中图分类号: R442.4

Combination detection of carbohydrate antigen 19-9,carbohydrate antigen 242 and carcinoembryonic antigen in differential diagnosis of benign and malignant obstructive jaundice

1. Department of General Surgery, The Second Affiliated Hospital of AnHui Medical University, Hefei Anhui 230000;
2. Department of General Surgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233040;
3. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China;
4. Department of Vascular Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China
CLC number: R442.4

摘要: 目的: 评价血清肿瘤标志物糖链抗原19-9(CA19-9)、糖链抗原242(CA242)及癌胚抗原(CEA)联合检测鉴别诊断良恶性梗阻性黄疸的临床价值。方法: 采用免疫放射分析法对88例恶性梗阻性黄疸患者和52例良性梗阻性黄疸患者的血清CA19-9、CA242和CEA进行检测,绘制ROC曲线并计算曲线下面积(AUC),对CA19-9、CA242和CEA单独及联合检测的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比进行分析。结果: CA19-9、CA242和CEA在恶性梗阻性黄疸组的水平均显著高于良性梗阻性黄疸组(P < 0.01),CA19-9、CA242和CEA、AUC分别为0.882、0.904和0.843,阳性似然比依次为1.96、6.04和10.44,阴性似然比依次为0.11、0.30和0.42。系列联合检测(三项检查)阳性,其特异性较单项检查明显增高;而平行联合检测(三项检查中有一项为阳性)阳性,则灵敏度较单项检查明显增高。结论: CA19-9、CA242及CEA联合检测对鉴别良恶性梗阻性黄疸有一定的临床意义。
- 黄疸 /
- 糖链抗原19-9 /
- 糖链抗原242 /
- 癌胚抗原 /
- 鉴别诊断
Abstract: Objective: To evaluate the clinical significance of serum tumor markers carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 242(CA242) and carcinoembryonic antigen (CEA) in differential diagnosis of benign and malignant obstructive jaundice. Methods: Serum levels of CA199,CA242 and CEA were detected by radioimmunoassay in 88 patients with malignant obstructive jaundice and 52 patients with benign obstructive jaundice. The receiver-operating characteristics curve (ROC) of the three serum tumor markers was made and the areas under the curve (AUC) were calculated. The sensitivity,specificity,positive predict value,negative predict value,positive likelihood ratio and negative likelihood ratio of CA199,CA242 and CEA were calculated and analyzed. Results: CA19-9,CA242 and CEA in patients with malignant obstructive jaundice were significantly higher than those in patients with benign obstructive jaundice (P < 0.01). The AUC of CA19-9,CA242 and CEA were 0.882,0.904 and 0.843,respectively. The positive likelihood ratio priority of CA19-9,CA242 and CEA were 1.96,6.04 and 10.44,respectively,and the negative likelihood ratio priority was 0.11,0.30 and 0.42,respectively. Serial combination testing increased the diagnostic specificity,and parallel combination testing increased the diagnostic sensitivity. Conclusions: Combined measurement of serum CA19-9,CA242 and CEA is valuable in differential diagnosis of benign and malignant obstructive jaundice.
- jaundice /
- carbohydrate antigen 19-9 /
- carbohydrate antigen 242 /
- carcinoembryonic antigen /
- differential diagnosis

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CA19-9、CA242及CEA联合检测在良恶性梗阻性黄疸鉴别诊断中的应用

作者简介: 褚亮(1981-),男,硕士研究生,主治医师.

1. 安徽医科大学第二附属医院普外科, 安徽合肥, 230000;
2. 蚌埠医学院第二附属医院普外科, 安徽蚌埠 233040;
3. 蚌埠医学院第一附属医院肝胆外科, 安徽蚌埠 233004;
4. 蚌埠医学院第一附属医院血管外科, 安徽蚌埠 233004

收稿日期: 2011-02-01

关键词:

摘要: 目的: 评价血清肿瘤标志物糖链抗原19-9(CA19-9)、糖链抗原242(CA242)及癌胚抗原(CEA)联合检测鉴别诊断良恶性梗阻性黄疸的临床价值。方法: 采用免疫放射分析法对88例恶性梗阻性黄疸患者和52例良性梗阻性黄疸患者的血清CA19-9、CA242和CEA进行检测,绘制ROC曲线并计算曲线下面积(AUC),对CA19-9、CA242和CEA单独及联合检测的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比进行分析。结果: CA19-9、CA242和CEA在恶性梗阻性黄疸组的水平均显著高于良性梗阻性黄疸组(P < 0.01),CA19-9、CA242和CEA、AUC分别为0.882、0.904和0.843,阳性似然比依次为1.96、6.04和10.44,阴性似然比依次为0.11、0.30和0.42。系列联合检测(三项检查)阳性,其特异性较单项检查明显增高;而平行联合检测(三项检查中有一项为阳性)阳性,则灵敏度较单项检查明显增高。结论: CA19-9、CA242及CEA联合检测对鉴别良恶性梗阻性黄疸有一定的临床意义。

English Abstract

Combination detection of carbohydrate antigen 19-9,carbohydrate antigen 242 and carcinoembryonic antigen in differential diagnosis of benign and malignant obstructive jaundice

1. Department of General Surgery, The Second Affiliated Hospital of AnHui Medical University, Hefei Anhui 230000;
2. Department of General Surgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233040;
3. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China;
4. Department of Vascular Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

Received Date: 2011-02-01

Abstract: Objective: To evaluate the clinical significance of serum tumor markers carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 242(CA242) and carcinoembryonic antigen (CEA) in differential diagnosis of benign and malignant obstructive jaundice. Methods: Serum levels of CA199,CA242 and CEA were detected by radioimmunoassay in 88 patients with malignant obstructive jaundice and 52 patients with benign obstructive jaundice. The receiver-operating characteristics curve (ROC) of the three serum tumor markers was made and the areas under the curve (AUC) were calculated. The sensitivity,specificity,positive predict value,negative predict value,positive likelihood ratio and negative likelihood ratio of CA199,CA242 and CEA were calculated and analyzed. Results: CA19-9,CA242 and CEA in patients with malignant obstructive jaundice were significantly higher than those in patients with benign obstructive jaundice (P < 0.01). The AUC of CA19-9,CA242 and CEA were 0.882,0.904 and 0.843,respectively. The positive likelihood ratio priority of CA19-9,CA242 and CEA were 1.96,6.04 and 10.44,respectively,and the negative likelihood ratio priority was 0.11,0.30 and 0.42,respectively. Serial combination testing increased the diagnostic specificity,and parallel combination testing increased the diagnostic sensitivity. Conclusions: Combined measurement of serum CA19-9,CA242 and CEA is valuable in differential diagnosis of benign and malignant obstructive jaundice.