CA199与CA242在良恶性消化系统疾病诊断中的价值

摘要

Objective To investigate the clinical significance of CA199 and CA242 in diagnosis of be-nign and malignant digestive system diseases, and to provide scientific basis for clinicians to select CA199 or CA242 as the diagnosis indicator for benign and malignant digestive system diseases. Methods Flow fluores-cence method was used to detect the serum levels of CA199 and CA242 in 65 patients with benign digestive system diseases and 45 patients with malignant digestive system diseases.χ² test was used to compare the sen-sitivity and specificity of CA242 and CA199, Fisher′s exact probabilities method was used to compare the sen-sitivity of CA199 and CA242 in diagnosis of various malignant digestive diseases. The positive predictive val-ue, the negative predictive value, the positive likelihood ratio and the negative likelihood ratio of CA242 and CA199 were calculated. Results Serum CA199 and CA242 in malignant digestive system disease patients (725.91 ± 337.94)U/mL and (228.33 ± 118.95)U/mL, was higher than that in benign digestive disease patients (310 ± 249.14)U/mL and (97.25 ± 114.39)U/mL(P<0.001). The sensitivity of CA199 and CA242 in diagnosis of malignant digestive system diseases were 93.33%and 82.22%, and the difference was not statistically signif-icant (P>0.05). The specificity of CA199 and CA242 in diagnosis of malignant digestive system diseases was 69.23%and 84.62%, and the difference was statistically significant (P<0.05). The sensitivity of CA199 and CA242 to all kinds of malignant digestive system diseases was not statistically significant (P>0.05). Conclu-sions CA199 and CA242 had certain clinical significance in diagnosis of benign and malignant digestive sys-tem diseases, and CA242 was better than CA199 in the diagnostic power. CA242 could significantly improve the diagnostic specificity without significantly affecting the detection sensitivity.%目的：探讨CA199与CA242在良恶性消化系统疾病诊断中的临床意义，为临床医生选择CA199或CA242作为良恶性消化系统疾病的诊断指标提供依据。方法采用流式荧光发光法对65例良性消化系统疾病患者和45例恶性消化系统疾病患者的血清CA199、CA242进行检测，采用χ²检验比较CA199、CA242的灵敏度和特异度，采用Fisher确切概率法比较CA199、CA242在各类恶性消化系统疾病诊断中的灵敏度，计算CA199、CA242的阳性预测值、阴性预测值、阳性似然比、阴性似然比等指标。结果恶性消化系统疾病患者血清CA199与CA242的含量为（725.91±337.94）U/mL和（228.33±118.95） U/mL,明显高于良性消化系统疾病患者（310±249.14）U/mL 和（97.25±114.39）U/mL，（P 均<0.001）；CA199、CA242对恶性消化系统疾病诊断的灵敏度分别为93.33%、82.22%，差异无统计学意义（P>0.05），CA199、CA242对恶性消化系统疾病诊断的特异度分别为69.23%，84.62%，差异有统计学意义（P<0.05）；CA199、CA242对各类恶性消化系统疾病诊断的灵敏度均无统计学意义（P均>0.05）。结论血清CA199和CA242对于良、恶性消化系统疾病的诊断有一定临床意义，且CA242的诊断价值高于CA199，在不显著影响检测灵敏度的情况下，可显著提高诊断的特异度。