Hammel P, Voitot H, Vilgrain V, Lévy P, Ruszniewski P, Bernades P
Fédération Médico-Chirurgicale d'Hépato-Gastroentérologie, Hôpital Beaujon, Clichy, France.
Eur J Gastroenterol Hepatol. 1998 Apr;10(4):345-8. doi: 10.1097/00042737-199804000-00012.
Mucinous cystic tumours of the pancreas need to be distinguished from other cystic lesions because of their malignant potential. The aim of this study was to assess prospectively the reliability of CA 72-4 and carcinoembryonic antigen analysis in the fluid of cystic lesions of the pancreas obtained by fine-needle aspiration for pathological diagnosis.
CA 72-4 and carcinoembryonic antigen were measured in cyst fluid obtained preoperatively by fine-needle aspiration. The 91 lesions consisted of 16 serous cystadenomas, 16 mucinous cystadenomas, 14 cystadenocarcinomas and 45 pancreatic pseudocysts complicating well documented chronic pancreatitis.
A CA 72-4 level of >40 U/ml had a 63% sensitivity and 98% specificity for distinguishing mucinous cystadenomas and cystadenocarcinomas from serous cystadenomas and pseudocysts. A carcinoembryonic antigen level of >400 ng/ml had a 57% sensitivity and a 100% specificity for distinguishing mucinous tumours and cystadenocarcinomas from pseudocysts. A carcinoembryonic antigen level of <4 ng/ml had a 100% sensitivity and a 93% specificity for distinguishing serous cystadenomas from mucinous cystadenomas, cystadenocarcinomas and pseudocysts.
Combined measurement of CA 72-4 and carcinoembryonic antigen may be used to distinguish accurately mucinous cystadenomas and cystadenocarcinomas from serous cystadenomas and pseudocysts.
胰腺黏液性囊性肿瘤因其具有恶变潜能，需要与其他囊性病变相鉴别。本研究旨在前瞻性评估通过细针穿刺获取的胰腺囊性病变液中CA 72 - 4和癌胚抗原分析对病理诊断的可靠性。
对术前通过细针穿刺获取的囊液进行CA 72 - 4和癌胚抗原检测。91个病变包括16个浆液性囊腺瘤、16个黏液性囊腺瘤、14个囊腺癌以及45个并发有充分记录的慢性胰腺炎的胰腺假性囊肿。
CA 72 - 4水平>40 U/ml对鉴别黏液性囊腺瘤和囊腺癌与浆液性囊腺瘤及假性囊肿的敏感性为63%，特异性为98%。癌胚抗原水平>400 ng/ml对鉴别黏液性肿瘤和囊腺癌与假性囊肿的敏感性为57%，特异性为100%。癌胚抗原水平<4 ng/ml对鉴别浆液性囊腺瘤与黏液性囊腺瘤、囊腺癌及假性囊肿的敏感性为100%，特异性为93%。
联合检测CA 72 - 4和癌胚抗原可用于准确鉴别黏液性囊腺瘤和囊腺癌与浆液性囊腺瘤及假性囊肿。
