The Clinical Analysis Of Tumor Marker CA19-9 And CEA In Diagnosis Of Cholangiocarcinoma

Early symptoms of cholangiocarcinoma are not typical,apparent in most of the patients had clinical manifestations are advanced,so the surgical resection rate and poor prognosis.Early diagnosis and treatment of cholangiocarcinoma can improve the prognosis of patients with bile duct cancer and prolong survival, but there is still a lack of bile duct cancer with high sensitivity and specificity of strong screening method.To improve the accuracy of the diagnosis of cholang- iocarcinoma is often required at the same time ultrasound,endoscopic retrograde cholangio pancreatography (ERCP),computed tomography (CT),magnetic resonance imaging (MRI), magnetic resonance cholangio pancreatography (MR CP), percutaneous transhepatic cholangiography (PTC) and other checks,not only bring significant economic burden on patients,but also may be associated with a number of serious complications associated with the inspection.Find cholangiocarcinoma diagnosed with high sensitivity and specificity of qualitative diagnostic method for patients to choose the appropriate treatment,has been the focus of clinicians.With the development of biotechnology,tumor markers of emering new technologies,more and more tumor-associated antigen test be applied to the diagnosis of cholangiocarci noma.CA19-9 and CEA in the diagnosis of digestive tract tumors have a higher sensitivity and specificity,it is committed by many of the liver,gallbladder, pancreas tumor marker studies scholars attention.Because single serum CA19-9 and CEA failed to meet the ideal sensitivity and specificity,following the detection of serum tumor markers alone,after a growing number of related research tends to the joint detection of the two complement each other to increase through the tumor diagnosis.Combined detection of a large number of research reports indicate that although a certain extent,improved the sensitivity or specificity,but still difficult to meet the sensitivity and specificity were high demand.And serum markers of the body vulnerable to many factors,in the biliary tract infection,bile duct benign lesions of serum CA19-9 and CEA values can also be significantly increased in the detection of the relatively high false positive and false negative,so that diagnosis reduced.Living in the bile as bile duct cells,the environment,combined with bile salts on the role of cell membrane damage,bile tumor marker levels much higher than the blood more likely to be detected,and there is reported in the literature, the sensitivity and special foreign body are high.Therefore,the domestic and foreign scholars have put forth bile tumor marker test in order to enhance its good evil differential diagnosis of the disease.Throughout the past few years the study of bile tumor marker reports indicate that in the "bile duct bile in patients with tumor marker CA19-9 and CEA levels increased significantly higher than in the blood between the two can increase the detection rate of cholangiocarcinoma "is concerned,many researchers have recognized more uniform,but for the joint detection of bile CA19-9 and CEA in the diagnosis of cholangiocarcinoma in the sensitivity and specificity are quite different to the joint detection of both diagnostic value of bile duct carcinoma is as yet no unified understanding . In this study, the positive cutoff value of serum markers obtained from the protein microarray technology manufacturers to provide the normal: CA19-9 <35.00 KU / L, CEA <5.00ng/ml. Normal bile markers to calculate the control group, more than as a positive community values, its normal were: CA19-9: 35.75±20.94KU / L, CEA: 6.12±8.94ng/ml; its boundary values are: CA19-9: 56.00KU / L, CEA: 15.00ng/ml.Based on the above numerical statistics found that bile duct cancer patients serum and bile CA19-9 and CEA levels were significantly higher than control group patients cholangiocarcinoma bile CA19-9 and CEA levels were significantly higher than the serum levels of both.Control group,bile CA19-9 and CEA levels in serum than the control group while both increased,but the magnitude was significantly lower than cholangiocarcinoma group,bile and serum in comparison.In view of experiment shown in bile CA19-9 diagnosis of bile duct of the sensitivity of high serum CEA higher diagnostic specificity of bile duct carcinoma,so the two combined detection to determine their diagnostic value of cholangiocarcinoma.The results showed that bile CA19-9,serum CEA combined detection and diagnosis of cholangiocarcino- ma sensitivity,specificity effectiveness,false-positive rates were 55.56%,93.33%,78.94%,0,the sensitivity and specificity were high ,effectiveness,and false-positive rates with other indicators of joint detection of significant difference.See bile CA19-9, combined detection of serum CEA value in the diagnosis of cholangiocarcinoma is superior to serum and bile tumor markers alone or in combination testing, the diagnosis of bile duct an effective indicator.Now,summarized this study as follows: Objective: To evaluate the value of detecting tumor markers CA19-9and CEA in the bile for diagnosis of cholangiocarcinoma.Methods: Choose 27 patients with bile duct carcinome conformed by pathological specimens in the Hepatopancreatobiliary Surgery Department of The 3rd Hospital of Jin Lin University from September 2008 to January 2010,over the same period 30 patients with benign bile duct,respectively,as the observation group and control group respectively.Before ERCP,we extracted 3ml venous blood from all the patients in each group,preserved for inspection. All patients were in the ERCP patients, the injection of contrast agent prior to sterile syringes through the imaging tubes two consecutive points to take bile, the same batch determination CA19-9 and CEA.The positive cutoff value of serum markers obtained from the protein microarray technology manufacturers to provide the normal: CA19-9 <35.00 KU / L, CEA <5.00ng/ml. Normal bile markers to calculate the control group, more than as a positive community values, its normal were: CA19-9: 35.75±20.94KU / L, CEA: 6.12±8.94ng/ml; its boundary values are: CA19-9: 56.00KU / L, CEA: 15.00ng/ml.Compared with the control group were observed in serum and bile CA19-9, CEA level and the observed group differences in bile of patients with CA19-9, CEA levels and serum levels of difference between the two; Based on the above boundary value to bile or serum CA19-9 , CEA also determined for the positive test positive for the joint were compared in serum and bile CA19-9, CEA alone, combined detection of bile duct cancer diagnosis. Conclusion: The bile CA19-9 and CEA levels of Patients with cholangio- carcinoma are significantly higher than both of them in the serum,compared with significant difference (P <0.01).The volue of bile tumor marker CA19-9 and CEA in diagnosis of cholangiocarcinoma is superior than serum CA19-9 and CEA .Combined detection of bile CA19-9 and serum CEA joint detection can significantly improve the specificity of diagnosis of cholangiocarcinoma and it is of great valve for the differential diagnosis of cholangiocarcinoma and benign bile duct stricture.