摘要
目的探讨血清和胆汁CA72-4对良恶性梗阻性黄疸的鉴别诊断价值。方法收集2020年6月1日至2022年6月1日因梗阻性黄疸就诊于福建医科大学附属福州市第一医院需行内镜逆行性胰胆管造影术(ERCP)检查或治疗患者,最终纳入67例患者,分为良性组和恶性组。术前抽取血清标本,ERCP术中抽取胆汁标本检测进行肿瘤标志物CA72-4检测。结果肿瘤标志物CA72-4在胆汁中明显高于血清,差异有统计学意义(P<0.05),恶性组胆汁及血清CA72-4高于良性组,差异有统计学意义(P<0.05)。根据受试者工作特征(ROC)曲线所示血清、胆汁CA72-4诊断恶性梗阻性黄疸的最佳临界值为1.84、7.10 U/ml。血清CA72-4诊断恶性梗阻性黄疸的敏感度和特异度分别为63.30%、86.50%,胆汁CA72-4的敏感度和特异度分别为83.30%、89.20%。良性组和恶性组中血清和胆汁CA72-4与总胆红素无相关性(P>0.05)。结论血清和胆汁CA72-4检测可以作为判断良恶性梗阻性黄疸的鉴别诊断方法,其中胆汁CA72-4诊断效能优于血清CA72-4。
Objective To explore the differential diagnostic value of serum CA72-4 and bile CA72-4 in benign and malignant obstructive jaundice(MOJ).Methods From June 1,2020,to June 1,2022,a total of 67 patients for endoscopic retrograde cholangiopancreatography(ERCP)examination or treatment in Fuzhou No.1 Hospital Affiliated with Fujian Medical University due to obstructive jaundice were enrolled and divided into benign and malignant groups.Serum samples were extracted before surgery,and bile samples were extracted during ERCP for tumor marker CA72-4 detection.Results The tumor marker CA72-4 was significantly higher in bile than in serum,with statistically significant difference(P<0.05).The bile and serum CA72-4 levels in the malignant group were higher than those in the benign group,with statistically significant differences(P<0.05).According to the Receiver Operating Characteristic(ROC)curve,the optimal cutoff values for serum and bile CA72-4 in diagnosing MOJ are 1.84 U/ml and 7.10 U/ml,respectively.Serum CA72-4 has a sensitivity of 63.30% and a specificity of 86.50% for the diagnosis of MOJ,while the sensitivity and specificity of bile CA72-4 were 83.30% and 89.20%,respectively.There was no correlation in serum and bile CA72-4 and total bilirubin levels between the benign and malignant groups(P>0.05).Conclusion The detection of serum CA72-4 and bile CA72-4 can be used as a differential diagnosis method for benign and malignant obstructive jaundice,with bile CA72-4 having better diagnostic efficacy than serum CA72-4.
作者
陈泽宇
陈煜杉
李晨辉
郭磊
刘新飞
邱丽雯
林晖
CHEN Zeyu;CHEN Yushan;LI Chenhui;GUO Lei;LIU Xinfei;QIU Liwen;LIN Hui(Digestive Endoscopy Room,Fuzhou No.1 Hospital Affiliated with Fujian Medical University,Fujian,Fuzhou 350001,China;Department of Gastroenterology,Fuzhou No.1 Hospital Affiliated with Fujian Medical University,Fujian,Fuzhou 350001,China)
出处
《中国医药科学》
2024年第1期170-174,共5页
China Medicine And Pharmacy
基金
福建省福州市科技计划项目(2021-S-177)。
