[CA19-9和癌胚抗原在预测肝门部胆管癌可切除性中的价值]

[The value of CA19-9 and CEA in predicting resectability of hilar cholangiocarcinoma].

作者信息

Zong Di, Zeng Yong

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2014 Sep;45(5):819-22.

Abstract

OBJECTIVE

To evaluate the predictability of preoperative serum Carbonhydrate antigen (CA19-9) and Carcino-embryonic antigen (CEA) for tumor resectability in the patients with hilar cholangiocarcinoma (HC).

METHODS

One hundred and three HC patients pathologically diagnosed from 2003 to 2012 were divided into radical resection group and palliative treatment group according to their surgical therapy and resection results, and preoperative serum CA19-9 and CEA data was collected and analyzed retrospectively. Receiver operating characteristic (ROC) curve analysis was applied to find the best cut-off point, and the resectability prediction of different detection methods was evaluated.

RESULTS

In the application of ROC analysis, the cut-off point of CA19-9 and CEA were 400 microg/L and 8 microg/L with the largest Youden's index 0. 2345 (AUC = 0.605 +/- 0.057) and 0. 1635 (AUC = 0.631 +/- 0.055) respectively. The ROC-AUC, sensitivity, specificity, negative predictive value and positive predictive value in the combine detection (parallel test) with this new cut-off point were 0.660 +/- 0.054, 62.79%, 65.00%, 56.25% and 83.33% respectively.

CONCLUSION

The HC patients with "CA19-9 < 400 microg/L + CEA < 8 microg/L" may have big opportunity to have radical resection while those with "CA19-9 > or = 400 microg/L or CEA > or = 8 microg/L" may have small opportunity.

摘要

目的

评估术前血清糖类抗原（CA19-9）和癌胚抗原（CEA）对肝门部胆管癌（HC）患者肿瘤可切除性的预测价值。

方法

回顾性收集并分析2003年至2012年经病理诊断的103例HC患者的临床资料，根据手术治疗及切除结果将患者分为根治性切除组和姑息治疗组，收集术前血清CA19-9和CEA数据。采用受试者工作特征（ROC）曲线分析确定最佳截断点，并评估不同检测方法对可切除性的预测价值。

结果

ROC分析显示，CA19-9和CEA的截断点分别为400μg/L和8μg/L，最大约登指数分别为0.2345（AUC = 0.605±0.057）和0.1635（AUC = 0.631±0.055）。采用该截断点进行联合检测（平行试验）时，ROC-AUC、灵敏度、特异度、阴性预测值和阳性预测值分别为0.660±0.054、62.79%、65.00%、56.25%和83.33%。