Evaluation of Serum CA 19-9 in Malignant Tumors

惡性腫瘤病人血清醣抗原CA19-9濃度之評估

丁慧枝(Hueich-Jy Ding) ； 吳重慶(Chung-Chieng Wu) ； 楊朝欽(Chao-Chin Yang) ； 吳莉莉(Li-Li Wu) ； 何幸淑(Shing-Shwu Her) ； 柯成國(Chen-Guo Ker) ； 黃宗人(Tsung-Jen Huang)

《The Kaohsiung Journal of Medical Sciences》 3卷6期 (1987/06) Pp. 400-406

https://doi.org/10.6452/KJMS.198706.0400

摘要

為了瞭解血清中醣抗原CA 19-9在各種惡性腫瘤及非惡性腫瘤診斷上之意義，評估測量值的準確性與精密度，我們自民國74年1月至75年3月間，收集了112位惡性腫瘤及非惡性腫瘤和42位正常人之血清，以放射免疫分析方法進行分析，利用目前已發展之單株抗體19-9測定血清中中醣抗原CA19-9的濃度。實驗結果發現血清中CA19-9在5.58至120.0單位/毫升範圍內之平均CV值為8.2%，最低測定濃度可低至4.8單位/毫升，回收率在90%至108%，正常人之平均值為11.6±5.2單位/毫升。在非惡性腫瘤42位病人中有11.4%超過正常值〈37單位/毫升〉。惡性腫瘤病人血清中CA19-9超越正常值的比例分述如下：胰臟癌：100%〈3/3〉，膽道癌：100%〈4/4〉，大腸癌100%〈3/3〉，肝癌50%〈4/8〉，肝轉移癌：40%〈2/5〉，胃癌7.7%〈1/13〉，肺癌0%〈0/10〉，卵巢癌0%〈0/2〉，adenocarcinoma of papilla of Vater 0%〈0/4〉，食道癌0%〈0/3〉。CA19-9在惡性腫瘤診斷上，敏感度為36.4%，特異性為88.6%，診斷上準確性為52.7%。因此我們可以推論： CA19-9是一個很有價值的腫瘤標記，尤其是胰臟癌、膽道癌和總膽管癌在診斷上會有所助益。但在非惡性腫瘤疾病中膽曩病患血清中CA19-9濃度超過正常值的可能性很大。

並列摘要

Carbohydrate antigen (CA 19-9), a tumor-associated antigen by recently developed immunoradiometric assays utilizing monoclonal antibody 19-9, was evaluated in the serum of 42 healthy adults and 112 patients with and without malignant diseases. The assay is sensitive and simple to perform. The average coefficient of variation (CV) is 8.2% in a range of 5.8 to 120.0 units/ml. The minimum detectable dose is 4.8 units/ml and analytical recovery of CA 19-9 is 90%to 108%. The mean ±SD of the CA 19-9 in 42 healthy adults was 11.6±5.2 units/ml with a range of 5.6 to 28.4 units/ml. Based on a concentration of 37 units/ml as the upper normal limit, the false positive rate is 11.4%(4/35) and the true positive rates in malignancies were as follows: 100% (3/3) in pancreatic carcinoma. 100% (4/4) in cholangio-carcinoma, 50% (11/22) in colon carcinoma, 100% (3/3) in common bile duct carcinoma, 50% (4/8) in hepatocellular carcinoma, 40% (2/5) in liver metastasis, 7.7% (1/3) in gastric carcinoma, 0% (0/10) in lung carcinoma, 0% (0/2) in ovarian carcinoma, 0% (0/4) in adenocarcinoma of papilla of Vater and 0% (0/3) in esophageal carcinoma, respectively. The overall sensitively, specificity and diagnostic accuracy of CA 19-9 in the diagnosis of malignant tumors were 36.4%, 88.6%, and 52.7% respectively. It is concluded that CA 19-9 is a valuable tumor marker, especially in the diagnosis of pancreatic carcinoma, cholangio carcinoma and common bile duct carcinoma. However, non-malignant disease of the gall bladder (G.B) may also have elevated serum level of CA 19-9.

並列關鍵字

quality control ； carbohydrate antigen 19-9 (CA 19-9) ； malignant tumors