Forsmark C E, Lambiase L, Vogel S B
Department of Medicine, University of Florida, Gainesville.
Pancreas. 1994 Nov;9(6):731-4. doi: 10.1097/00006676-199411000-00010.
Marked elevations of the tumor-associated antigen CA19-9 are relatively specific for pancreatic carcinoma and are associated with more advanced malignancies. We retrospectively reviewed 53 patients with CA19-9 values > 90 U/ml in whom the test had been done because of clinical suspicion of pancreatic malignancy. Pancreatic cancer was found in 45 patients (85%). If a cutoff value of CA19-9 > 200 U/ml is used, 36 of 37 (97%) patients had pancreatic cancer. Thirty patients with pancreatic cancer and no radiographic criteria of unresectability underwent attempted resection; five of these patients were judged to be potentially resectable and four of them underwent attempted resection. In only one patient with a CA19-9 value > 300 U/ml was resection possible; this patient had advanced carcinoma. Our results suggest that, in patients in whom the clinician suspects pancreatic carcinoma, CA19-9 > 90 U/ml is highly suggestive of pancreatic malignancy, while CA19-9 > 200 U/ml is virtually diagnostic of pancreatic malignancy. In similar patients with CA19-9 > 300 U/ml, resection is rarely possible and tumors are advanced.
肿瘤相关抗原CA19-9的显著升高对胰腺癌具有相对特异性，且与更晚期的恶性肿瘤相关。我们回顾性分析了53例CA19-9值>90 U/ml的患者，这些患者因临床怀疑胰腺恶性肿瘤而进行了该项检测。45例（85%）患者被诊断为胰腺癌。如果采用CA19-9>200 U/ml的临界值，37例患者中有36例（97%）患有胰腺癌。30例胰腺癌患者且无影像学不可切除标准，尝试进行手术切除；其中5例患者被判定为可能可切除，4例患者接受了手术尝试。仅1例CA19-9值>300 U/ml的患者可行手术切除；该患者患有晚期癌。我们的结果表明，在临床怀疑胰腺癌的患者中，CA19-9>90 U/ml高度提示胰腺恶性肿瘤，而CA19-9>200 U/ml几乎可诊断胰腺恶性肿瘤。在CA19-9>300 U/ml的类似患者中，很少可行手术切除且肿瘤为晚期。
