联合检测血清CA19-9,CEA和尿酸在鉴别诊断胆管癌与胆道良性疾病中的意义

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目的:探讨CA19-9,CEA及肝肾功能各生化指标在胆管癌与胆道良性病患者血清中的变化规律以及其对于鉴别诊断胆管癌和胆道良性病和在术前评估中的意义。方法:用电化学发光免疫法和生化比色法测定并分析5年间采集的胆管癌48例、胆道良性病32例及正常人31例血清中CA19-9,CEA和肝肾功能各生化指标的含量。结果:与正常人相比,胆管癌组和胆道良性病组CA19-9,TBIL,DBIL,AST及ALT水平均显著升高(P<0.01),而尿酸水平显著下降(P<0.01),肌酐水平在3组间的差异无统计学意义(P>0.05)。胆管癌组血清中CA19-9水平明显高于良性胆道病组(P<0.05),而CEA在胆管癌组与胆道良性病组之间差异无统计学意义(P>0.05)。单项检测中血清CA19-9的敏感性最高达75%(36/48)。胆管癌组内,CA19-9与TBIL均呈低度正相关性(r=0.351,P=0.014),与DBIL的相关性有统计学意义(r=0.33,P=0.022)。结论:胆管癌与胆道良性病患者都存在不同程度的肝肾功能损害,联合测定CA19-9,CEA,尿酸对胆管癌及胆道良性病的鉴别诊断具有一定的参考意义。 Objective: To investigate the changes of serum CA19-9, CEA, liver and kidney function in serum of patients with cholangiocarcinoma and biliary benign disease and its significance in the differential diagnosis of cholangiocarcinoma and biliary benign disease and their preoperative evaluation. Methods: The chemiluminescence immunoassay and biochemical colorimetric method were used to detect and analyze the serum CA19-9, CEA, liver and kidney function in 48 cases of cholangiocarcinoma, 32 cases of biliary benign disease and 31 cases of normal biliary tract in 5 years content. Results: The levels of CA19-9, TBIL, DBIL, AST and ALT in cholangiocarcinoma group and biliary benign disease group were significantly higher than those in normal group (P <0.01), while the levels of uric acid were significantly decreased (P <0.01) There was no significant difference in the levels between the three groups (P> 0.05). Serum levels of CA19-9 in cholangiocarcinoma group were significantly higher than those in benign cholangiocarcinoma group (P <0.05), while there was no significant difference in CEA between cholangiocarcinoma group and biliary benign disease group (P> 0.05). The sensitivity of serum CA19-9 in single test was up to 75% (36/48). In cholangiocarcinoma group, there was a low positive correlation between CA19-9 and TBIL (r = 0.351, P = 0.014), and the correlation with DBIL was statistically significant (r = 0.33, P = 0.022). Conclusion: There are different degrees of liver and kidney dysfunction in patients with cholangiocarcinoma and biliary benign disease. The combined determination of CA19-9, CEA and uric acid has certain reference value in the differential diagnosis of cholangiocarcinoma and biliary tract benign disease.
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