Cwik Grzegorz, Wallner Grzegorz, Skoczylas Tomasz, Ciechanski Aleksander, Zinkiewicz Krzysztof
Second Department of General Surgery, Skubiszewski Medical University of Lublin, Lublin, Poland.
Arch Surg. 2006 Oct;141(10):968-73; discussion 974. doi: 10.1001/archsurg.141.10.968.
Accurate differentiation between inflammatory and neoplastic tumors of the pancreas remains a diagnostic dilemma for surgeons. The aim of the study was to assess the utility of 2 neoplastic markers, cancer antigen (CA) 19-9 and CA 125, in the differential diagnosis of pancreatic tumors.
The patients were assigned to a malignant or benign group based on cytological and histological evaluation of pancreatic lesion samples. The serum from each patient was tested for CA 19-9 and CA 125.
One hundred ten patients with heterogeneous pancreatic lesions (inflammatory and malignant tumors) treated at a surgical department of a university hospital were analyzed.
Samples for cytological and histological evaluation were taken during ultrasonography-guided fine-needle aspiration biopsy or open surgery.
Sensitivity, specificity, and positive and negative predictive values of each test in the differential diagnosis of pancreatic tumors were determined.
The sensitivity, specificity, positive predictive value, and negative predictive value of the CA 19-9 test were 80.8%, 89.1%, 93.7%, and 89.2%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the CA 125 test were 60.8%, 83.3%, 88.2%, and 50.8%, respectively. The sensitivity and specificity of a combined evaluation of both CA 19-9 and CA 125 tests were 87.8% and 77.8%, respectively.
Taking into account the high but still limited sensitivity and specificity of the CA 19-9 and CA 125 tests, their results in the differential diagnosis of pancreatic tumors should be interpreted consistently and in reference to imaging techniques such as ultrasonography and computed tomography.
准确区分胰腺炎性肿瘤和肿瘤性肿瘤对外科医生来说仍然是一个诊断难题。本研究的目的是评估两种肿瘤标志物，癌抗原（CA）19-9和CA 125在胰腺肿瘤鉴别诊断中的效用。
根据胰腺病变样本的细胞学和组织学评估，将患者分为恶性或良性组。检测每位患者血清中的CA 19-9和CA 125。
分析了在一家大学医院外科接受治疗的110例患有异质性胰腺病变（炎性和恶性肿瘤）的患者。
在超声引导下细针穿刺活检或开放手术期间采集用于细胞学和组织学评估的样本。
确定每项检测在胰腺肿瘤鉴别诊断中的敏感性、特异性、阳性预测值和阴性预测值。
CA 19-9检测的敏感性、特异性、阳性预测值和阴性预测值分别为80.8%、89.1%、93.7%和89.2%。CA 125检测的敏感性、特异性、阳性预测值和阴性预测值分别为60.8%、83.3%、88.2%和50.8%。CA 19-9和CA 125联合评估的敏感性和特异性分别为87.8%和77.8%。
考虑到CA 19-9和CA 125检测的敏感性和特异性虽高但仍有限，其在胰腺肿瘤鉴别诊断中的结果应结合超声和计算机断层扫描等成像技术进行统一解释。
