Malesci A, Tommasini M A, Bonato C, Bocchia P, Bersani M, Zerbi A, Beretta E, Di Carlo V
Gastroenterology. 1987 Jan;92(1):60-7. doi: 10.1016/0016-5085(87)90840-7.
Serum CA 19-9 levels were measured in 63 patients with ductal pancreatic adenocarcinoma and in 49 patients with chronic pancreatitis. Concentrations were abnormally high (greater than 40 U/ml) in 57 (90%) patients with cancer and only in 5 (10%) patients with chronic pancreatitis. All patients with falsely normal serum values had poorly differentiated carcinomas. Median CA 19-9 concentrations were progressively higher in patients with more advanced cancer. Fifteen of 16 (93%) patients with localized cancer has abnormal serum levels but only 5 (31%) of them had values greater than 120 U/ml, which was the highest score observed in patients with chronic pancreatitis. Pure pancreatic juice was obtained endoscopically from 23 patients with pancreatic cancer and from 20 with chronic pancreatitis. CA 19-9 concentrations in pancreatic juice were significantly higher in patients with cancer than in non-neoplastic patients. All 11 patients with resectable cancer investigated had a ratio of CA 19-9 to secretory protein concentration in pancreatic juice above the range of patients with chronic pancreatitis. We conclude that serum CA 19-9 determination is highly sensitive and specific for the differential diagnosis of pancreatic cancer versus chronic pancreatitis. However, moderately increased values (less than 120 U/ml), as seen in patients with localized pancreatic adenocarcinoma, are not conclusive for malignancy. The measurement of CA 19-9 to total protein ratio in pure pancreatic juice is proposed as an adjunctive, accurate diagnostic marker for early stages of pancreatic adenocarcinoma.
对63例胰腺导管腺癌患者和49例慢性胰腺炎患者测定了血清CA 19-9水平。57例（90%）癌症患者的CA 19-9浓度异常升高（大于40 U/ml），而慢性胰腺炎患者中只有5例（10%）升高。血清值假正常的所有患者均为低分化癌。癌症分期越晚的患者，CA 19-９浓度中位数越高。16例局限性癌症患者中有15例（93%）血清水平异常，但其中只有5例（31%）的值大于120 U/ml，这是慢性胰腺炎患者中观察到的最高值。通过内镜从23例胰腺癌患者和20例慢性胰腺炎患者中获取了纯胰液。胰腺癌患者胰液中的CA 19-9浓度显著高于非肿瘤患者。所有11例接受研究的可切除癌症患者胰液中CA 19-9与分泌蛋白浓度的比值均高于慢性胰腺炎患者的范围。我们得出结论，血清CA 19-9测定对胰腺癌与慢性胰腺炎的鉴别诊断具有高度敏感性和特异性。然而，局限性胰腺腺癌患者中所见的中度升高值（小于120 U/ml）不能确诊为恶性肿瘤。建议测定纯胰液中CA 19-9与总蛋白的比值，作为胰腺腺癌早期阶段的辅助性准确诊断标志物。
