CA 242作为胆囊癌肿瘤标志物的评估
Evaluation of CA 242 as a tumor marker in gallbladder cancer.
作者信息
Rana Surinder, Dutta Usha, Kochhar Rakesh, Rana Satyavati V, Gupta Rajesh, Pal Ravinder, Jain Kapil, Srinivasan Radhika, Nagi Birender, Nain Chander Kant, Singh Kartar
机构信息
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
出版信息
J Gastrointest Cancer. 2012 Jun;43(2):267-71. doi: 10.1007/s12029-011-9288-7.
PURPOSE
Gallbladder and pancreas share common embryological origin, and malignancies of these organs may share common tumor antigens. CA 242 is a tumor marker for pancreatic cancer, but has not been studied in gallbladder cancer (GBC). We measured serum CA 242 levels in patients with GBC and compared it with those in patients with gallstones (GS) and healthy volunteers.
METHODS
We enrolled consecutive patients with GBC (cases), GS (disease controls), and healthy volunteers (healthy controls). Serum CA 242, CEA, and CA 19-9 levels were measured using ELISA. Receiver operator curve was plotted for all the three markers.
RESULTS
We studied 117 patients with GBC, 58 with GS, and 10 healthy volunteers. Among patients with GBC, 81 (69%) also had GB calculi. Patients with GBC more often had elevated CA 242 levels (64%) compared to those with GS (17%; p < 0.001) and healthy controls (0%; p < 0.001). The median levels of CA 242 was higher in the GBC group (59 [199] U/ml) compared to the GS group (10 [13] U/ml; p < 0.001) and the control group (3 [14.5] U/ml; p < 0.001). The sensitivity, specificity, positive predictive value (PPV), and negative predictive values of CA 242 for diagnosis of GBC were 64%, 83%, 88%, and 53%, respectively. At a cutoff of 45 U/ml, the specificity and PPV increased to 100%. CA 242 had higher AOC (0.759) compared to CEA (0.528) and CA 19-9 (0.430).
CONCLUSIONS
CA 242 is a promising tumor marker for GBC and performs better than CEA and CA 19-9.
目的
胆囊和胰腺有着共同的胚胎学起源，这些器官的恶性肿瘤可能具有共同的肿瘤抗原。CA 242是胰腺癌的一种肿瘤标志物，但尚未在胆囊癌（GBC）中进行研究。我们检测了GBC患者的血清CA 242水平，并将其与胆结石（GS）患者和健康志愿者的水平进行比较。
方法
我们纳入了连续的GBC患者（病例组）、GS患者（疾病对照组）和健康志愿者（健康对照组）。使用酶联免疫吸附测定法检测血清CA 242、癌胚抗原（CEA）和CA 19-9水平。为所有这三种标志物绘制了受试者工作特征曲线。
结果
我们研究了117例GBC患者、58例GS患者和10名健康志愿者。在GBC患者中，81例（69%）也有胆囊结石。与GS患者（17%；p＜0.001）和健康对照组（0%；p＜0.001）相比，GBC患者CA 242水平升高的情况更常见（64%）。GBC组CA 242的中位水平（59[199]U/ml）高于GS组（10[13]U/ml；p＜0.001）和对照组（3[14.5]U/ml；p＜0.001）。CA 242诊断GBC的敏感性、特异性、阳性预测值（PPV）和阴性预测值分别为64%、83%、88%和53%。在临界值为45 U/ml时，特异性和PPV提高到100%。与CEA（0.528）和CA 19-9（0.430）相比，CA 242有更高的曲线下面积（AUC，0.759）。
结论
CA 242是一种有前景的GBC肿瘤标志物，其表现优于CEA和CA 19-9。
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