Plebani M, Fabris C, Basso D, Del Favero G, Angonese C, Leandro G, Di Mario F, Burlina A, Naccarato R
Istituto di Medicina Interna (Cattedra di Malattie Apparato Digerente), Policlinico Universitario, Padova, Italy.
Int J Pancreatol. 1988;3 Suppl 1:S113-7.
In this paper the clinical usefulness of CEA and ferritin in the diagnosis of pancreatic cancer was pointed out. CEA was found to be increased in 51% of patients with pancreatic cancer; it was also abnormal in 22% of chronic pancreatitis and 31% of extra-pancreatic diseases. In patients with metastatic pancreatic cancer CEA was found to be more elevated than in those with localized tumor. CEA correlated with the age of the subjects in all material; in liver cirrhosis with IgG and in extra-pancreatic gastro-intestinal malignancies with alkaline-phosphatase. Ferritin was found to be increased in 73% of pancreatic cancer patients; it was also abnormal in 40% of chronic pancreatitis and in 38% of extra-pancreatic diseases. Patients with chronic pancreatitis studied during a relapsing phase all had elevated serum ferritin. We can conclude that neither CEA nor ferritin are useful indices of pancreatic malignancy, due to the lack of sensitivity or specificity. Both are influenced by several factors: CEA mainly by age and liver dysfunction, ferritin by the presence of an acute inflammation with cell necrosis.
本文指出了癌胚抗原（CEA）和铁蛋白在胰腺癌诊断中的临床应用价值。发现51%的胰腺癌患者CEA升高；22%的慢性胰腺炎患者和31%的胰腺外疾病患者CEA也异常。在转移性胰腺癌患者中，CEA比局限性肿瘤患者升高得更明显。在所有研究对象中，CEA与年龄相关；在肝硬化患者中与免疫球蛋白G（IgG）相关，在胰腺外胃肠道恶性肿瘤患者中与碱性磷酸酶相关。发现73%的胰腺癌患者铁蛋白升高；40%的慢性胰腺炎患者和38%的胰腺外疾病患者铁蛋白也异常。处于复发期的慢性胰腺炎患者血清铁蛋白均升高。我们可以得出结论，由于缺乏敏感性或特异性，CEA和铁蛋白都不是胰腺癌的有用指标。两者都受多种因素影响：CEA主要受年龄和肝功能障碍影响，铁蛋白受伴有细胞坏死的急性炎症影响。
