Tao Lian-Yuan, Cai Lei, He Xiao-Dong, Liu Wei, Qu Qiang
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Am Surg. 2010 Nov;76(11):1210-3.
Serum tumor markers such as alpha-fetoprotein (AFP), carcinoembryonic antigen, carbohydrate antigen (CA) 19-9, CA242, and CA50 were analyzed to evaluate their diagnostic values in single and combined tests for distinguishing intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). Preoperative serum levels of AFP, carcinoembryonic antigen, CA19-9, CA242, and CA50 were measured in 45 ICC and 76 HCC patients. The serum levels and the positive rate of AFP, CA19-9, and CA242 were significantly different between the ICC patients and HCC patients. Although AFP (-) was the most sensitive assay for distinguishing ICC from HCC (91.1%), its specificity was significantly lower than that of CA242 (+) and CA19-9 (+). The combination of AFP (-) and CA242 (+) afforded a high specificity of 94.3 per cent and showed highest accuracy (78.5%). Evaluation of patients without liver cirrhosis also showed similar results. The diagnostic value of CA242 (+) is better than that of CA19-9 (+) and AFP (-) in distinguishing ICC from HCC. Combined detection of AFP (-) and CA242 (+) can improve the specificity and accuracy of diagnosing ICC.
分析血清肿瘤标志物，如甲胎蛋白（AFP）、癌胚抗原、糖类抗原（CA）19-9、CA242和CA50，以评估它们在区分肝内胆管癌（ICC）与肝细胞癌（HCC）的单项和联合检测中的诊断价值。对45例ICC患者和76例HCC患者术前测定AFP、癌胚抗原、CA19-9、CA242和CA50的血清水平。ICC患者与HCC患者的AFP、CA19-9和CA242的血清水平及阳性率存在显著差异。虽然AFP（-）是区分ICC与HCC最敏感的检测方法（91.1%），但其特异性显著低于CA242（+）和CA19-9（+）。AFP（-）与CA242（+）联合检测的特异性高达94.3%，准确性最高（78.5%）。对无肝硬化患者的评估也显示出类似结果。在区分ICC与HCC方面，CA242（+）的诊断价值优于CA19-9（+）和AFP（-）。联合检测AFP（-）和CA242（+）可提高ICC诊断的特异性和准确性。
