Pinto M M, Levine R H
Department of Cytology, Bridgeport Hospital, Connecticut.
Am J Gastroenterol. 1992 Apr;87(4):530-3.
Carcinoembryonic antigen (CEA) was measured in 21 consecutive fine needle aspirates (FNA) of solid pancreatic lesions from 20 patients to determine whether elevated levels would predict the presence of pancreatic carcinoma in cytologically negative aspirates. Final diagnoses were correlated with clinical, radiologic, and pathologic (four patients) findings and follow-up. Twenty aspirates had malignancy, and one was benign. FNAs were performed under radiologic guidance with a 22-gauge Chiba needle and a 20-ml syringe. Cytologic examination was rendered on Papanicolaou-stained slides and, when available, hematoxylin and eosin-stained cell blocks. CEA was measured by enzyme immunoassay (Abbott Laboratories). Sensitivity of cytologic diagnosis was 80%; specificity was 100%. With 5 ng/ml as cutoff, the sensitivity of CEA for malignancy was 70% and for adenocarcinoma of pancreas, 78%; the specificity was 100%. The mean CEA in pancreatic carcinoma was 152.1 ng/ml (range 1.4 to greater than 880 ng/ml). The mean CEA for lymphoma, metastatic lung carcinoma, and benign aspirate was 1.0 ng/ml. Elevated CEA was diagnostic of pancreatic carcinoma in three cytologically negative aspirates. Combined sensitivity of CEA and cytology was 95%. Elevated CEA in FNA of pancreas increases the sensitivity of cytologic diagnosis and may suggest carcinoma in cytologically negative aspirates.
对20例患者的21份连续的胰腺实性病变细针穿刺抽吸物（FNA）进行癌胚抗原（CEA）检测，以确定CEA水平升高是否能预测细胞学检查阴性的抽吸物中是否存在胰腺癌。最终诊断与临床、放射学及病理学（4例患者）检查结果以及随访情况相关。20份抽吸物为恶性，1份为良性。FNA在放射学引导下，使用22号千叶针和20毫升注射器进行。对巴氏染色玻片进行细胞学检查，如有条件，也对苏木精和伊红染色的细胞块进行检查。CEA采用酶免疫测定法（雅培实验室）检测。细胞学诊断的敏感性为80%；特异性为100%。以5 ng/ml为临界值，CEA对恶性肿瘤的敏感性为70%，对胰腺腺癌的敏感性为78%；特异性为100%。胰腺癌中CEA的平均水平为152.1 ng/ml（范围为1.4至大于880 ng/ml）。淋巴瘤、转移性肺癌及良性抽吸物的CEA平均水平为1.0 ng/ml。在3份细胞学检查阴性的抽吸物中，CEA升高可诊断为胰腺癌。CEA与细胞学检查的联合敏感性为95%。胰腺FNA中CEA升高可提高细胞学诊断的敏感性，并可能提示细胞学检查阴性的抽吸物中存在癌。
