Dual-Phase Spiral CT Combined With CA19-9: Research On Pancreatic Carcinoma Resectability Before Surgery

Object To investigate the value of dual-phase helical computed tomography (CT) combined with CA19-9 in assessing the resectability of patients with pancreatic carcinoma. Method There are 51 patients who are diagnosed as pancreatic carcinoma by dual-phase helical computed tomography scan at NO.1 hospital Shanxi Medical University. All patients CT appearances and serum level of CA19-9 were retrospectively studied. According to pathologic examination of the resected speciman or, if unresceted , clinic final diagnosis, All patients were divided into 3 groups: A. Localized . B. Locally advanced. C. Metastasis.Collecting randomly 15 patients with choledocholithiasis presenting jaundice as contrast group, all patients had serum CA19-9 and total bilirubin examination results. Stastical analysis was performed by SPSS10.0 software. Result: For prediction of unresectabiliy, helical CT had accuracy of 100%,for prediction of resectability , the accuracy was 73.3%. The level of serum CA19-9 increased along with advancing of tumor, the means of serum CA19-9 between group A and group C have statistically significance (P<0.05),but the means between group B and group A, group B and group C all had not statistically significance(P>0.05). If using CA19-9 level of 150 as a threshold to determine unresectability, in our study, of the 37 patients who preoperative CT imaging demonstrated unresectability, only 10 (24%) patients CA19-9 level higher than 150; on the other hand, of the 15 patients who preoperative CT imaging demonstrated resectability, 4 patients is unresectability actually, all their serum CA19-9 level were lower than 150. Conclusion (1) The level of serum CA19-9 increased along with advancing of tumor, but the level of serum CA19-9 can not to reflect tumor local invasion. (2) The jaundice and different examination method of serum CA19-9 all may effect the CA19-9 examination result, so we can make a conclusion that dual-phase helical CT combined with CA19-9 are not well than dual-phase helical CT in evaluating the pancreatic carcinoma.