摘要
目的探讨并分析血清糖链抗原（CA）19-9、CA24-2在良恶性胆道疾病中的诊断价值。方法选取2012年1月-2015年10月于河北北方学院附属第一医院消化内科和普外科住院的胆道疾病患者214例,根据病变性质分为胆道良性病变组（n=162）和恶性病变（胆管癌）组（n=52）,另选取同期体检中心健康体检者作为正常对照组（n=40）。所有研究对象均在空腹状态下抽取外周静脉血,检测血清TBil、DBil、IBil,采用放射免疫法测定血清CA19-9、CA24-2水平。计量资料多组样本间比较采用Kruskal-Wallis H检验,进一步两两比较采用Wilcoxon秩和检验;计数资料组间比较采用χ^2检验;采用Pearson相关分析法进行相关性分析。结果与正常对照组相比,良、恶性胆道病变组患者血清TBil、CA19-9水平均升高,差异均有统计学意义（P值均〈0.01）;与胆道良性病变组相比,胆道恶性病变患者血清CA19-9和CA24-2水平均显著升高,差异均有统计学意义（P值均〈0.01）。血清CA19-9、CA24-2水平与胆管癌组织学肿瘤位置无关,与组织学不同分化程度有关（χ^2值分别为6.860、9.010,P值均〈0.05）。联合检测CA19-9与CA24-2诊断胆管癌的敏感度为88.5%,特异性为82.1%,高于二者单独检测的敏感度和特异性,差异均有统计学意义（P值均〈0.01）。良性胆道疾病与胆管癌患者血清CA19-9水平与血清TBil水平均呈正相关（r值分别为0.634、0.346,P值均〈0.05）。结论联合检测CA19-9和CA24-2对胆管癌早期诊断具有临床意义。
Objective To investigate the value of serum carbohydrate antigen 19- 9（ CA19- 9） and carbohydrate antigen 24- 2（ CA24-2） in the diagnosis of benign and malignant biliary tract diseases. Methods A total of 214 patients with biliary tract diseases who were hospitalized in Department of Gastroenterology and Department of General Surgery in the First Hospital Affiliated to Hebei North University from January 2012 to October 2015 were enrolled,and according to the nature of lesions,they were divided into benign lesion group（ 162 patients） and malignant lesion group（ 52 patients）. The healthy people who underwent physical examination during the same period of time in the Physical Examination Center were enrolled as normal control group（ 40 persons）. Peripheral venous blood was collected for all subjects in a fasting state,and the serum levels of total bilirubin（ TBil）,direct bilirubin（ DBil）,and indirect bilirubin（ IBil） were measured. Radioimmunoassay was used to measure the serum levels of CA19- 9 and CA24- 2. The Kruskal- Wallis H test was used for comparison of continuous data between multiple groups,and the Wilcoxon rank sum test was used for further comparison between any two groups; the chi-square test was used for comparison of categorical data between groups; Pearson correlation analysis was also performed. Results Compared with the normal control group,the benign lesion group and the malignant lesion group showed significant increases in the serum levels of TBil and CA19- 9（ all P〈0. 01）. Compared with the benign lesion group,the malignant lesion group showed significant increases in the serum levels of CA19- 9 and CA24- 2（ all P〈0. 01）. The serum levels of CA19- 9 and CA24- 2 were not associated with tumor location in cholangiocarcinoma,but they were associated with the degree of tumor differentiation（ χ^2= 6. 860 and 9. 010,all P〈0. 05）. The combined measurementof CA 1 9- 9 and CA 2 4- 2 had a sensitivity of 8 8. 5 % and a specificity of 8 2. 1 % in the diagnosis of cholangiocarcinoma,which were significantly higher than the sensitivity and specificity of CA19- 9 or CA24- 2 measurement（ all P〈0. 01）. In the patients with benign biliary tract diseases and cholangiocarcinoma,serum CA19- 9 was positively correlated with serum TBil（ r = 0. 634 and 0. 346,both P〈0. 05）,and the benign lesion group had a significantly greater correlation between serum CA19- 9 and serum TBil than the malignant lesion group. Conclusion Combined measurement of CA19- 9 and CA24- 2 has clinical significance in early diagnosis of cholangiocarcinoma.
出处
《临床肝胆病杂志》
CAS
2016年第7期1364-1367,共4页
Journal of Clinical Hepatology
基金
张家口市2014年度科学技术研究与发展计划自筹项目(1421150D)
关键词
胆道疾病
抗原
肿瘤相关
碳水化合物
诊断
biliary tract diseases
antigens
tumor-associated
carbohydrate
diagnosis
