翟福英 潘旭萍

[摘要] 目的 探讨肿瘤标志物CA199 联合CA242测定用于纠正高胆红素血症对良性疾病患者CA199检测的假阳性结果。方法 对78例良性肝胆疾病伴有高胆红素血症患者血清进行肿瘤标志物AFP、CEA、CA199、CA125及CA153的浓度检测，CA199检测为阳性的标本，增加CA242 测定并在临床有效治疗无高胆红素血症后复查CA199和CA242。结果 高胆红素血症对良性疾病患者CA199的测定影响较大，对CA242影响较小，经治疗无高胆红素血症后复查CA199阳性率显著下降，由治疗前76.9%降低到治疗后5.13%。 结论 CA242可以纠正CA199在高胆红素血症影响下良性疾病的假阳性结果，对于良恶性疾病的鉴别有重要意义。

[关键词] 高胆红素血症；CA199；CA242

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2015）08（c）-0071-02

Influence of Hyperbilirubinemia on CA199 Detection in Patients with Benign Disease

ZHAI Fu-ying， PAN Xu-ping

Department of Clinical Laboratory， Rongcheng People's Hospital， Rongcheng， Shandong Province， 264300 China

[Abstract] Objective To investigate the combined determination of tumor markers CA199 and CA242 in correcting the false positive result， which is caused by hyperbilirubinemia， after CA199 detection in patients with benign disease. Methods The detection of tumor markers AFP， CEA， CA199， CA125， CA153 in serum was conducted in 78 patients with benign hepatobiliary diseases combined with hyperbilirubinemia， and for those specimens which obtained positive results， CA242 detection was performed additionally and re-determination of CA199 and CA242 after hyperbilirubinemia was treated effectively was done. Results Hyperbilirubinemia had more influence on CA199 detection but little on CA242 detection in patients with benign disease. Re-determination demonstrated that positive rate of CA199 detection was significantly lower after hyperbilirubinemia disappeared than that before， 5.13% vs 76.9%. Conclusion For patients with benign disease， combined determination of tumor markers CA199 and CA242 can correct the false positive results after CA199 detection which may be influenced by hyperbilirubinemia， therefore it is of great significance to the differentiation of benign and malignant diseases.

[Key words] Hyperbilirubinemia； CA199； CA242

肿瘤标志物是抗原和其他生物活性物质，它是由肿瘤细胞在发生和增殖过程中产生或分泌的，然后释放到细胞体液和血液中，通常在正常组织及良性病变中不产生该物质[1]。在临床实践中发现肿瘤标志物阳性结果存在于一些良性疾病中，尤其是肝、胆、胰良性疾病伴有高胆红素血症的患者样本CA199假阳性较多。据文献报道[2-3]CA242具有和CA199相似的肿瘤标志意义，受高胆红素影响较小，在良恶性疾患的表达中有非常显著差异。故该实验室收集2011年3月—2013年12月该院的住院病例78例，探讨用联合测定CA242和CA199来纠正高胆红素血症对肝、胆、胰良性疾病患者CA199测定结果的影响，现报道如下。

1 资料与方法

1.1 一般资料

整群选取肝胆胰良性疾病伴有高胆红素血症患者血清78例，男45例，女33例，年龄在31～72岁，平均年龄（46.7±3.8）岁。……