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[肿瘤标志物CA 19-9和癌胚抗原(CEA)在胰腺癌诊断、治疗及预后中的作用]

[Role of the tumor markers CA 19-9 and carcinoembryonic antigen (CEA) in diagnosis, treatment and prognosis of pancreatic cancer].

作者信息

Kokhanenko N Iu, Ignashov A M, Varga E V, Polkanova M S, Aleshina L A, Kimbarovskaia A A, Osipenko S K, Lebedev E G

机构信息

I.P. Pavlov State Medical University, Consultative-Diagnostic Center No. 85, St. Petersburg.

出版信息

Vopr Onkol. 2001;47(3):294-7.

Abstract

The investigation was concerned with diagnostic sensitivity, specificity and effectiveness of assay of CA 19-9 and carcinoembryonic antigen (CEA) in the choice of treatment modality and evaluation of therapy pancreatic carcinoma (PC). Either marker has been studied in 685 examinations for PC, 68--chronic pseudotumorous pancreatitis and 24--intestinal cancer at other sites since 1995. Tumor resection for PC was carried out in 31; conservative treatment--67; chemotherapy--56 and radiotherapy--in 29 cases. In CA 19-9 examinations, diagnostic sensitivity was 90.2; specificity--72.1 and effectiveness--85.3%, while in CEA determinations, 82.5; 30.9 and 68.5%, respectively. CA 19-9 and CEA levels proved to be prognostic factors of survival. An inverse correlation was observed between median survival and tumor marker concentrations: higher basal (preoperative) level of marker in blood was matched by lower median survival. A similar relationship was identified for CEA: 5-10--14.2 months; 10.1-20 ng/ml--8.0 months; 20.1-30 ng/ml--3.9 months, and more than 30 ng/ml--4.8 months. There was a direct correlation between CA 19-9 level and tumor stage. The dynamics of tumor markers, particularly, CA 19-9 correlated with treatment effectiveness during its course.

摘要

该研究关注CA 19-9和癌胚抗原(CEA)检测在胰腺癌(PC)治疗方式选择及疗效评估中的诊断敏感性、特异性和有效性。自1995年以来,对685例PC检查、68例慢性假瘤性胰腺炎及24例其他部位的肠癌均进行了这两种标志物的检测。31例PC患者接受了肿瘤切除术;67例接受了保守治疗;56例接受了化疗;29例接受了放疗。CA 19-9检测中,诊断敏感性为90.2%;特异性为72.1%;有效性为85.3%,而CEA检测中,诊断敏感性、特异性和有效性分别为82.5%、30.9%和68.5%。CA 19-9和CEA水平被证明是生存的预后因素。观察到中位生存期与肿瘤标志物浓度呈负相关:血液中标志物的基础(术前)水平越高,中位生存期越低。CEA也有类似关系:5-10 ng/ml时为14.2个月;10.1-20 ng/ml时为8.0个月;20.1-30 ng/ml时为3.9个月;超过30 ng/ml时为4.8个月。CA 19-9水平与肿瘤分期呈正相关。肿瘤标志物的动态变化,尤其是CA 19-9的动态变化与治疗过程中的疗效相关。

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