췌장암에서 혈청 CA 19-9와 CA 125의 유용성

Abstract

Background/Aims: Trial to diagnose pancreatic cancer with CA 19-9 and CA125 has been continued, but study is rare to predict extensiveness of pancreatic cancer with CA 19-9 and CA 125. This study is conducted to evaluate the diagnostic accuracy of CA 19-9 and CA 125 for diagnosing pancreatic cancer and verify the usefulness of CA 19-9 and CA 125 to predict extensiveness of pancreatic cancer. Method: The serum level of CA 19-9 or CA 125 were determined by radioimmunometric assay in 218 patients. We analysed 67 cases of pancreatic cancer according to T, N, M stage, size, resectibility to verify the usefulness of CA 19-9 and CA 125 to predict extensiveness of pancreatic cancer. Result: The upper cutoff point of normal range was determined as 37 U/ml for CA 19-9 and 35 U/ml for CA 125 respectively. The sensitivity of CA 19-9 and CA 125 was 67.2% and 44.4% and specificity was 71.4% and 66.7% The sensitivity and specificity of combined analysis was 76.8% and 57.1% respectively. Positive rate of CA 19-9 in patient with pancreatic cancer, benign pancreatic disease, gastrointestinal cancer other than pancreatic cancer was 67.2%, 28.6%, 31.5% respectively and positive rate of CA 125 was 44.4%, 33.3%, 32.4%. The positive rate of CA 19-9 in patient with biliary cancer and stomach cancer was 52.4% and 25.0% and positive rate of CA 125 was 26.3% and 50.5% respectively. So positive rate of CA 19-9 in patient with pancreatic cancer only was higher than other gastrointestinal cancer statistically. The positive rate of CA 19-9 in T3 stage was higher than T1 and T2 stage and the positive rate of CA 125 was higher in unresectable pancreatic cancer statistically. But the positive rate of CA 19-9 and CA 125 was not related with size, lymph node involvement and distant metastasis. Conclusions: Combined analysis of CA 19-9 and CA 125 was more sensitive than single analysis. Serum CA 19-9 and CA 125 may be useful to predict resectibility of pancreatic cancer.