血清 CA 19-9 和 CA 125 作为胆囊癌的诊断标志物。

Serum CA 19-9 and CA 125 as a diagnostic marker in carcinoma of gallbladder.

机构信息

Department of Pathology, Motilal Nehru Medical College, Allalhabad, Uttar Pradesh, India.

出版信息

Indian J Pathol Microbiol. 2021 Jan-Mar;64(1):65-68. doi: 10.4103/IJPM.IJPM_494_19.

DOI:10.4103/IJPM.IJPM_494_19

PMID:33433411

Abstract

BACKGROUND

Gall bladder carcinoma is endemic in North India along the Ganges belt. Most of the cases usually present in late stage when prognosis is poor. That mandates a necessity for proper screening in these areas for gall bladder lesions. Tumor markers CA 19-9 and CA 125 have been studied in various GI cancers and may also help in the screening, diagnosis and evaluation of gall bladder carcinoma. Aims: To assess serum CA19-9 and serum CA125 in patients with gall bladder lesions and find out a cut off value for diagnosis of carcinoma gallbladder.

METHODS AND MATERIAL

Study included 118 cases, with female: male ratio of 4:1.Out of it, 91 (77 %) cases were benign and 27 (23 %) were malignant. Patients' sera was collected and analyzed for CA19-9 and CA 125 by CMIA method.

RESULTS

The Mean (SD) value of CA19-9 for benign and malignant cases was found to be 12.86 (17.54) and 625.35(186.52) U/ml. For CA 125 it was found to be 17.98(13.69) and 239.63(73.72) U/ml respectively. The difference was statistically significant (P< 0.001). When Mean - 2SD value of malignant lesions were taken as cut off a value of CA 19-9 and CA 125 were found be 252.31 U/ml & 92.19U/ml respectively, found to be significant to suggest /diagnose a case of carcinoma gall bladder along with clinicoradiological findings. Taking these value as cut off Sensitivity & Specificity for CA 19-9 and CA 125 in detecting malignant cases were found to be 100% & 98.90% and 100% & 94.50% respectively.

CONCLUSIONS

It is concluded that both serum CA 19-9 and serum CA 125 may act as a good adjunct for diagnosis of cases of carcinoma gallbladder along with imaging studies. However, changes in CA19-9 are more significant than CA 125.

摘要

背景

印度北部恒河沿岸是胆囊癌的高发地区。大多数病例通常在晚期出现，预后较差。因此，在这些地区对胆囊病变进行适当的筛查是必要的。肿瘤标志物 CA 19-9 和 CA 125 已在各种胃肠道癌症中进行了研究，也可能有助于胆囊癌的筛查、诊断和评估。目的：评估胆囊病变患者血清 CA19-9 和 CA125，并确定诊断胆囊癌的截断值。

方法与材料

本研究共纳入 118 例患者，男女比例为 4:1。其中良性病例 91 例（77%），恶性病例 27 例（23%）。采集患者血清，采用 CMIA 法检测 CA19-9 和 CA125。

结果

良性和恶性病例的 CA19-9 平均值（标准差）分别为 12.86（17.54）和 625.35（186.52）U/ml。CA125 分别为 17.98（13.69）和 239.63（73.72）U/ml。差异有统计学意义（P<0.001）。当以恶性病变的平均值-2 倍标准差为截断值时，CA19-9 和 CA125 的值分别为 252.31 U/ml 和 92.19 U/ml，这与临床和影像学发现一起提示/诊断胆囊癌。以这些值作为截断值，CA19-9 和 CA125 对恶性病例的敏感性和特异性分别为 100%和 98.90%以及 100%和 94.50%。