Heptner G, Domschke S, Schneider M U, Siegfried W, Domschke W
Dtsch Med Wochenschr. 1986 Mar 7;111(10):374-8. doi: 10.1055/s-2008-1068458.
Tumour-associated antigens CA 50 and CA 19-9 were determined in serum of 208 patients. Specificity of both neo-antigens as tumour markers was equally good, at 100% and 95%, in patients without malignancy or gastrointestinal disease, respectively, using an upper limit of normal of 17 U/ml for CA 50 and 37 U/ml for CA 19-9. Benign diseases of the upper gastrointestinal tract, such as pancreatitis, cholestasis or cirrhosis of the liver, reduce the specificity of CA 50 more than of CA 19-9. For example, specificity of CA 50 is only 33% for choledocholithiasis, but 74% with CA 19-9. The sensitivity of both closely related sialogangliosides in malignancies of the upper GI tract is similar, with the usual normal limits: in pancreas carcinoma 77% for CA 50, 81% for CA 19-9; in biliary tract carcinoma 80% for CA 50, 90% for CA 19-9; in gastric carcinoma 40% for CA 50, 50% for CA 19-9. But if one equalizes the upper limits of normal for both markers to a common 95% specificity, the tumour-indicating sensitivity of CA 19-9 clearly surpasses that of CA 50. Malignant tumours not recognized by increased levels of CA 19-9 also escape serological diagnosis with CA 50.
对208例患者的血清进行了肿瘤相关抗原CA 50和CA 19 - 9的检测。对于无恶性肿瘤或胃肠道疾病的患者,这两种新抗原作为肿瘤标志物的特异性分别为100%和95%,其中CA 50的正常上限为17 U/ml,CA 19 - 9的正常上限为37 U/ml。上消化道良性疾病,如胰腺炎、胆汁淤积或肝硬化,对CA 50特异性的降低程度大于CA 19 - 9。例如,胆总管结石患者中CA 50的特异性仅为33%,而CA 19 - 9为74%。在上消化道恶性肿瘤中,这两种密切相关的唾液酸神经节苷脂的敏感性相似,正常范围如下:胰腺癌中CA 50为77%,CA 19 - 9为81%;胆管癌中CA 50为80%,CA 19 - 9为90%;胃癌中CA 50为40%,CA 19 - 9为50%。但如果将两种标志物的正常上限调整到共同的95%特异性水平,则CA 19 - 9的肿瘤指示敏感性明显超过CA 50。CA 19 - 9水平未升高而未被识别的恶性肿瘤,CA 50血清学诊断也无法检测出来。