Matsuda M, Shimizu Y, Chikamatsu E, Takayanagi K, Ishigure H, Murakami S, Odani K
Department of Surgery, Chukyo Hospital, Nagoya, Japan.
Nihon Geka Gakkai Zasshi. 1991 Jun;92(6):716-21.
To evaluate the clinical value in diagnosis of biliary and pancreatic cancer carcinoembryonic antigen (CEA), carbohydrate antigen (CA19-9) and cytology in the bile were examined in 343 patients with benign biliary disease and 71 patients with biliary and pancreatic cancer. An abnormal CEA level was defined as a level of more than 500 ng/ml in the gallbladder bile and 40 ng/ml in the bile duct bile. Increased bile CEA levels were observed in 50.0% in 22 patients with bile duct cancer, 60.0% in 20 with gallbladder cancer and 23.8% in 21 with pancreas cancer. False positive rate in 343 patients with benign diseases was only 1.2%. Bile CA19-9 levels were measured in 195 patients with benign disease and 30 with malignancy. However, the overlap between the values of the 2 groups was too great for differentiation of malignancy from benign disease. The positive rates of bile cytology were 52.2% in 23 patients with bile duct cancer, 40.0% in 15 with gallbladder cancer and 27.3% in 22 with pancreatic cancer. The diagnostic accuracies of combined assessment of bile CEA and cytology were 68.0% in 25 patients with bile duct cancer, 77.3% in 22 with gallbladder cancer and 37.5% in 24 with pancreatic cancer. The sensitivity of this combined test was 60.6% (43/71), and the specificity was 98.8% (339/343). This combined test is considered to be reliable screening test especially for biliary cancer.
为评估癌胚抗原（CEA）、糖类抗原（CA19-9）及胆汁细胞学检查对胆管癌和胰腺癌的临床诊断价值，对343例良性胆道疾病患者和71例胆管癌及胰腺癌患者进行了检测。异常CEA水平定义为胆囊胆汁中超过500 ng/ml，胆管胆汁中超过40 ng/ml。在22例胆管癌患者中，50.0%观察到胆汁CEA水平升高；20例胆囊癌患者中，60.0%升高；21例胰腺癌患者中，23.8%升高。343例良性疾病患者的假阳性率仅为1.2%。对195例良性疾病患者和30例恶性疾病患者检测了胆汁CA19-9水平。然而，两组数值之间的重叠太大，无法区分恶性疾病和良性疾病。胆管癌23例患者胆汁细胞学阳性率为52.2%，胆囊癌15例患者为40.0%，胰腺癌22例患者为27.3%。胆管癌25例患者胆汁CEA和细胞学联合评估的诊断准确率为68.0%，胆囊癌22例患者为77.3%，胰腺癌24例患者为37.5%。该联合检测的敏感性为60.6%（43/71），特异性为98.8%（339/343）。该联合检测被认为是一种可靠的筛查检测方法，尤其对于胆管癌。
