Pungpak S, Akai P S, Longenecker B M, Ho M, Befus A D, Bunnag D
Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Trans R Soc Trop Med Hyg. 1991 Mar-Apr;85(2):277-9. doi: 10.1016/0035-9203(91)90055-4.
Opisthorchiasis is a major public health problem in north-east Thailand, where over 7 million inhabitants are reported to be infected. A significant percentage of infected individuals develops cholangiocarcinoma terminally, which is rapidly fatal. To determine whether certain tumour markers are elevated in Thai patients with cholangiocarcinoma, and thus might be useful in the diagnosis of cholangiocarcinoma associated with opisthorchiasis in Thailand, the tumour markers CA125 and CA19-9 were measured by radioimmunoassay in 94 serum samples. The subjects consisted of 52 patients admitted for non-gastroenterological diseases, 7 patients with histologically proven cholangiocarcinoma, 7 patients with clinically suspected cholangiocarcinoma, and 28 patients with uncomplicated opisthorchiasis. The mean levels (+/- standard deviation [SD]) of CA19-9 and CA125 in the controls were 12.5 +/- 10.2 and 24.7 +/- 11.1 units/ml respectively. Using the mean + 3SD as the cut-off level, 57.1% of patients with confirmed cholangiocarcinoma had elevated CA19-9 and 28.6% had elevated CA125. In patients with clinically suspected cholangiocarcinoma, 71.4% had elevated CA19-9 and 28.6% had elevated CA125. Among opisthorchiasis patients, 3.6% had elevated CA125 and none had elevated CA19-9. 1.9% of controls had elevated CA19-9 and none had elevated CA125. When positivity of either CA125 or CA19-9 was used as an indicator of malignancy, the sensitivity and specificity of the combined tests reached 85.7% and 98.1% respectively. These preliminary results suggest that the measurement of CA125 and CA19-9 may be useful in the early detection of opisthorchiasis-associated cholangiocarcinoma.
肝吸虫病是泰国东北部一个主要的公共卫生问题，据报道，当地有超过700万居民受到感染。相当比例的感染者最终会发展为胆管癌，且这种癌症致死率很高。为了确定泰国胆管癌患者的某些肿瘤标志物是否升高，从而可能有助于诊断泰国与肝吸虫病相关的胆管癌，我们采用放射免疫分析法对94份血清样本中的肿瘤标志物CA125和CA19 - 9进行了检测。研究对象包括52例因非胃肠疾病入院的患者、7例经组织学证实为胆管癌的患者、7例临床疑似胆管癌的患者以及28例无并发症的肝吸虫病患者。对照组中CA19 - 9和CA125的平均水平（±标准差[SD]）分别为12.5±10.2和24.7±11.1单位/毫升。以平均值 + 3SD作为临界值，确诊胆管癌的患者中，57.1%的患者CA19 - 9升高，28.6%的患者CA125升高。临床疑似胆管癌的患者中，71.4%的患者CA19 - 9升高，28.6%的患者CA125升高。在肝吸虫病患者中，3.6%的患者CA125升高，无人CA19 - 9升高。1.9%的对照组患者CA19 - 9升高，无人CA125升高。当以CA125或CA19 - 9阳性作为恶性肿瘤的指标时，联合检测的灵敏度和特异度分别达到85.7%和98.1%。这些初步结果表明，检测CA125和CA19 - 9可能有助于早期发现与肝吸虫病相关的胆管癌。
