目的：探讨血清、胆汁 CA19－9、CEA、CA242联合诊断胆道良恶性肿瘤的临床价值。方法：对象为2013年10月－2015年2月来我院诊治的疑似恶性胆道肿瘤的患者202例，均行手术探查。所有患者均通过穿刺的方式取胆汁进行 CA19－9、CEA、CA242检测，比较不同疾病类型患者血清、胆汁中的 CA19－9、CEA、CA242检测水平，分析血清胆汁联合检测在胆道良恶性肿瘤中的诊断价值。结果：202例手术探查患者中，98例经病理证实为恶性胆道肿瘤患者、22例为良性胆道肿瘤患者，82例为其他胆道疾病。恶性胆道肿瘤与良性胆道肿瘤患者胆汁中 CA242、CA19－9和 CEA 的表达水平要显著性的高于在血清中的表达水平（P ＜0．05）；恶性肿瘤组患者的胆汁中 CA242、CA19－9和 CEA 检测水平均显著性高于良性肿瘤患者（P ＜0．05）；胆汁CA242、CA19－9和 CEA 联合诊断胆道恶性肿瘤的敏感率为33．66％，准确率为88．98％，特异性为91．16％，阳性率为35．24％。结论：利用胆汁中肿瘤标记物对胆道肿瘤的检测水平要高于血清中的水平，采用CA19－9、CEA、CA242的联合检测是诊断胆道肿瘤比较理想的组合。上述肿瘤标志物的组合能够提高胆道肿瘤良恶性的预判准确度，对于早期胆道良恶性肿瘤的发现、治疗具有十分重要的意义。%Objective:To investigate the value of serum,bile CA19 -9,CEA,CA242 in benign and malignant bili-ary tumor.Methods:All 202 patients were taken bile puncture and tested for CA19 -9,CEA,CA242,Results:Of 202 cases of surgical exploration patients,98 patients with pathologically proven malignant biliary cancer,22 cases of be-nign biliary cancer,82 cases of other biliary tract disease.Malignant bile duct cancer and patients with benign bile duct cancer bile in CA242,CA19 -9 and CEA expression level was significantly higher than in the serum levels(P <0.05).Patients with malignant bile CA242,CA19 -9 and CEA levels were significantly higher in patients with benign tumors(P <0.05).Bile CA242,CA19 -9 and CEA in diagnosis of biliary cancer sensitivity was 33.66%,accuracy was 88.98%,specificity 91.16%,the positive rate was 35.24%.Conclusion:Bile levels of tumor markers for bile duct cancer are higher than levels in serum,using CA19 -9,combined detection of CEA,CA242 diagnosis of bile duct cancer is an ideal combination.
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