【摘要】 探讨应用血清CA19- 9诊断消化系统肿瘤的临床应用价值及应用它鉴别胰腺肿瘤与胰腺炎时的阳性参考值选定。应用酶放大化学发光免疫分析法分别检测下列人群组的血清CA19- 9:对照组 (2 1名 )、消化道肿瘤组 (12 5例 ,其中胰腺肿瘤患者 7例 )和非肿瘤组 (387例 ,其中胰腺炎患者 15例 )。根据受试者工作特征曲线(ROC)分析结果并选定阳性参考值。结果表明 ,以 18.4kU/L作阳性参考值时 ,该方法对消化系统肿瘤的诊断敏感性为 6 0 .8% ,特异性相对于对照组和非肿瘤组分别为 95 .2 %和 6 8.2 % ;CA19- 9对胰腺肿瘤的诊断敏感性为 85 .7% ,特异性相对于对照组和非胰腺肿瘤组分别为 95 .0 %和 6 3.1%。胰腺肿瘤与胆道阻塞并发胰腺炎鉴别诊断的阳性参考值选取 37kU/L时 ,其诊断特异性从 13.3%提高到 4 6 .7%。这说明血清CA19- 9是一项协诊消化系统肿瘤 ,特别是胰腺肿瘤的可靠实验室指标 ;提高阳性参考值 ,有助于鉴别胰腺肿瘤与胰腺炎更多还原

【Abstract】 The article is to study the clinical significance of serum CA19-9 in diagnosing malignant tumor occurred in digestive system and to select cut off values for differentiating diagnosis of a pancreatic neoplasms and pancreatitis. Using chemiluminescence immunoassay, serum CA19-9 level of below subjects were analyzed: control group (n=21);digestive system neoplasm group (n=125, with 7 cases conformed as pancreatic cancer); non-neoplastic disease group (n=387, with 15 cases conformed as pancreatitis secondary to destructive cholangitis). Receiver operating characteristic (ROC) curve was used for analyzing results and selecting cut off values. When cut off value was 18.4kU/L, sensibility for conforming a digestive system neoplasm was 60.8%, while its related specificity against control group and non-neoplastic disease group was 95.2% and 68.2%, respectively. Sensibility for diagnosing pancreatic neoplasm was 85.7%, while its related specificity against control group and non-pancreatic origin tumor group was 95.0% and 63.1%, respectively. When 37kU/L was chosen as cut off value, specificity for differentiating diagnosis of pancreatic neoplasm and pancreatitis secondary to destructive cholangitis rose from 13.3% to 46.7%. Serum CA19-9 could be used as an aid in detecting digestive system neoplastic disease; it is a reliable marker for pancreatic neoplasm. Raising cut off value may help to differentiate pancreatic neoplasm and pancreatitis secondary to destructive cholangitis.更多还原