Objective To evaluate the value of the levels of CA19-9 in the serum and bile for diagnosis of diseases of billiary system.Methods Concentration of serum and bile CA19-9 was determined in 82 patients with cholangiocarcinoma and 85 patients with benign disease,and the results were being analyzed and evaluated by statistics.Results The level of serum and bile CA19-9 in diseases of cholangiocarcinoma was higher than benign disease (P ＜0.001),and the diagnostic value of bile CA19-9 was higher than serum CA19-9 with ROC.In accordance with evaluation indicators,the sensitivity,specificity,coincidence rate,positive predictive rate and negative predictive rate of bile CA19-9 were all higher than serum.And the sensitivity,coincidence rate and negative predictive rate were enhanced after combined measurement of serum and bile CA19-9.Conclusion The way of combined measurement of serum and bile CA19-9 is an important reference in early screening cholangiocarcinoma.%目的 探讨血清、胆汁CA19-9水平对胆管癌的早期诊断和鉴别诊断的价值.方法 对82例胆道恶性病变患者和85例胆道良性疾病者测定血清和胆汁的CA19-9水平,进行对比分析和评价.结果 恶性组患者血清、胆汁CA19-9水平均明显高于良性组患者(P＜0.001)；胆汁CA19-9诊断胆管癌的ROC曲线下面积为0.764,诊断价值高于血清的0.701；根据诊断评价指标,胆汁CA19-9灵敏度、特异度、符合率、阳性预测值和阴性预测值(57.90％、95.50％、77.25％、92.30％、70.43％)均高于血液CA19-9(50.90％,89.10％,70.66％,82.35％,65.62％),两项联合检测灵敏度、符合率及阴性预测值均有不同程度提高.结论 选择血清、胆汁CA19-9进行联合检测,在胆管癌的早期筛检中具有重要参考价值.
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