CEA,CA199 Clinical Analysis Of Serological Tests For The Diagnosis And Differential Diagnosis Of Digestive System Neoplasm Significance

Objective: Serum CEA and CA199 are common digestive tumor markers in clinical widely used in cancer screening, diagnosis, prognosis, etc. This study was to further investigate its clinical significance in the diagnosis and differential diagnosis of common digestive tumors.Method: Through case review, select the serum CEA, CA199 concentration data in 63 cases of chronic atrophic gastritis, 498 cases of gastric cancer, 53 cases of acute cholangitis, 113 cases of bile duct cancer, 116 cases of acute pancreatitis, 121 cases of pancreatic cancer that are diagnosed in General Hospital of Ningxia Medical University from Jan. 2013 to Feb. 2015. Use chi-square test, rank sum test to analyze the positive rate and concentration level in different groups,to study the differences of the positive rate and the serology concentration in three groups of digestive malignant and benign diseases.Result: 1.Serum CEA:(1)in chronic atrophic gastritis, gastric cancer; acute cholangitis, bile duct cancer; acute pancreatitis, pancreatic cancer, the positive rates are 1.6%, 19.9%(P=0.001); 1.6%, 15.0%(P=0.140); 2.6%, 35.5%(P=0.000); the median concentrations of serum CEA are 1.640ng/ml, 2.035ng/ml(P=0.001); 1.640ng/ml, 2.730ng/ml(P=0.000); 1.455ng/ml, 3.300ng/ml(P=0.000);(2)in chronic atrophic gastritis, early gastric cancer, advanced gastric cancer(without metastasis), advanced gastric cancer(with metastasis), the positive rates are 1.6%, 4.1%, 11.2%, 28.9%(P=0.000, only advanced gastric cancer(with metastasis) and the other three groups see pairwise comparisons P<0.008); the median concentrations are 1.640ng/ml, 1.715ng/ml, 1.655ng/ml, 22.620ng/ml(P=0.000, only advanced gastric cancer(with metastasis) and the other three groups see pairwise comparisons P<0.008);(3)in signet ring cell carcinoma, poorly differentiated adenocarcinoma, moderately differentiated adenocarcinoma, highly differentiated adenocarcinoma, the positive rates are 31.8%, 16.3%, 19.7%, 25.5%(P=0.062); the median concentrations are 3.280 ng/ml, 1.950ng/ml, 2.215ng/ml, 1.900ng/ml(P=0.082). 2.Serum CA199: in chronic atrophic gastritis, gastric cancer; acute cholangitis, bile duct cancer; acute pancreatitis, pancreatic cancer, the positive rates are 9.5%, 16.9%(P=0.192); 67.9%, 93.8%(P=0.000); 32.8%, 85.1%(P=0.000); the median concentrations are 8.060U/ml, 9.050U/ml(P=0.281); 55.030U/ml, 301.800U/ml(P=0.000); 14.375U/ml, 368.700U/ml(P=0.000).Conclusion: 1. Serum CEA has clinical value in the diagnosis and differential diagnosis of the benign and malignant diseases in stomach and pancreas, not the value of biliary disease; serum CA199 has large value in the diagnosis and differential diagnosis of benign and malignant diseases in bile duct and pancreas, not the value of stomach illness.2. Diagnostic significance of serum CEA in early gastric cancer and even advanced gastric cancer(without metastasis) isn’t meaningful.3.The expression of serum CEA is independent of the degree of differentiation of gastric adenocarcinoma.4. The expression of serum CEA in patients with chronic atrophic gastritis, acute cholangitis, acute pancreatitis and serum CA199 in chronic atrophic gastritis is not more than 1 times the upper limit of normal; Serum CA199 has high levels of expression in acute pancreatitis and acute cholangitis, especially obvious in acute cholangitis.