摘要
目的探讨血清和胆汁CA19-9、CEA检测对未见明显占位胆管良恶性病变的鉴别诊断。方法选取2016年9月至2018年12月间上海交通大学医学院附属新华医院崇明分院收治的行手术治疗后病理检验确诊的60例胆道肿瘤患者,术前血清和术中胆汁行CA19-9和CEA水平检测,根据病理结果分为良性组和恶性组,比较两组患者相关检测指标,对单一或联合检测在良恶性胆管肿瘤中的诊断价值进行讨论。结果患者检出胆管癌28例(恶性组)和良性病变32例(良性组)。恶性组患者血清和胆汁CA19-9、CEA水平均高于良性组,差异均有统计学意义(均P<0.05)。血清CA19-9和CEA单一检测,均有较高的对胆管癌诊断的辅助价值,ROC-AUC分别为0.845和0.728。血清CA19-9和CEA联合检测,灵敏度和特异度分别为0.864和0.875,联合模式诊断效能比单一指标较高。结论无创条件下,血清和胆汁CA19-9、CEA联合检测对无明显占位胆管良恶性病变有较高的诊断价值,临床可对胆管癌风险进行评估及是否采取进一步检查或治疗方案。
Objective To explore the significance of serum and bile CA19-9 and CEA detection for the differential diagnosis of benign and malignant lesions with no obvious space occupying.Methods Sixty patients which were confirmed with biliary duct cancer by pathological examination after the surgery at Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from September 2016 to December 2018 as the research subjects.The preoperative and intraoperative bile and serum CA19-9 and CEA test were performed.According to the result of pathology,they were divided into a benign group and a malignant group.The levels of related markers were compared between the two groups and the diagnostic value of detection of single or joint markers for benign and malignant bile duct cancer was discussed.Results Twenty-eight patients were diagnosed with biliary duct cancer(malignant group)and32 patients were diagnosed with benign lesions(benign group).The levels of CA19-9 and CEA in the serum and bile were significantly higher in the malignant group than in the benign group(all P<0.05).Detection of single serum CA19-9 or CEA had high contributory diagnostic value for biliary duct cancer and ROC-AUC was 0.845 and 0.728,respectively.The sensitivity and specificity was 0.864 and 0.875,respectively for the combined detection of CA19-9 and CEA,which revealed that the diagnostic efficiency was significantly higher for the combined detection than for the single detection.Conclusion Under non-invasive conditions,combined serum CA19-9 and CEA test had a high diagnostic value for benign and malignant lesions without obvious occupying bile duct,which can be used to evaluate the risk of bile duct cancer in clinical practice,and determine whether further examination or treatment plan is needed.
作者
张莉
郁淼
周晔
冷俊
ZHANG Li;YU Miao;ZHOU Ye;LENG Jun(Department of Clinical Laboratory,Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 202150,China)
出处
《中国肿瘤临床与康复》
2020年第2期156-159,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
胆管肿瘤
良性
恶性
血清
胆汁
CA19-9
CEA
诊断价值
Biliary duct neoplasms
Benign
Malignant
Serum
Bile
Carbohydrate antigen 19-9
Carcinoembryonic antigen
Diagnostic value
