血清及胆汁中NGAL对于区分良恶性胆道狭窄的临床意义  

Serum and bile NGAL for clinically distinguishing malignant biliary strictures from benign biliary strictures

作　　者：韩美玲[1] 吕志武[1] 

机构地区：[1]哈尔滨医科大学附属第二医院消化内科,黑龙江省哈尔滨市150086

出　　处：《世界华人消化杂志》2014年第1期133-139,共7页World Chinese Journal of Digestology

摘　　要：目的:研究血清和胆汁中中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase associated lipocalin,NGAL)对于区分良恶性胆道狭窄的临床价值.方法:所研究患者是经内镜下逆行胰胆管造影进行胆道减压的患者.共44例胆总管扩张患者,恶性胆道狭窄患者共21例,其中胆管癌12例,胰腺癌8例,壶腹癌1例,良性胆道狭窄患者23例.收集患者血清和胆汁并采用酶联免疫吸附试验方法检测其中NGAL的含量,常规检测其他生化指标如血常规、肝功能等.结果:血清NGAL在区分良恶性胆道狭窄患者中没有明显区别,差异无统计学意义(平均值31.10 ng/mLvs 118.35 ng/mL,P=0.0825).比起良性胆道狭窄疾病患者,胆汁NGAL含量在恶性胆道狭窄患者中明显升高,差异有统计学意义(平均值199.0 ng/mLvs 466.7 ng/mL,P=0.0215).结论:胆汁而非血清中NGAL含量对于鉴别良恶性胆道狭窄患者有临床意义.AIM： To investigate the value of serum and bile neutrophil gelatinase associated lipocalin （NGAL） for distinguishing malignant strictures caused by cholangiocarcinoma （CCA） or pancreatic cancer from benign biliary strictures. METHODS： The study was performed prospectively on patients admitted for endoscopic retrograde cholangiopancreatography biliary decompression. Forty-four patients with dilated biliary ducts, including 12 cases of CCA, 8 cases of pancreatic cancer, 1 case of carcinoma of the ampulla, and 23 cases of benign biliary strictures, were enrolled. Their sera and bile were collected to measure NGAL. Routine biochemistry including liver function test and routine blood examination was also performed. Enzyme-linked immunosorbent assay was performed to measure the contents of NGAL in serum and bile samples. RESULTS： Serum NGAL had no significant value for discriminating malignant and benign biliary strictures （mean, 31.10 ng/mL vs 118.35 ng/mL, P = 0.0825）. Biliary NGAL levels were significantly raised in the malignant disease group compared with the benign disease group （mean, 199.0 ng/mL vs 466.7 ng/mL, P = 0.0215）. CONCLUSION： Measurement of biliary NGAL, not serum NGAL, may differentiate malignant biliary strictures from benign biliary strictures.

关 键 词：良性胆道狭窄 恶性胆道狭窄 胆管癌 胰腺癌 NGAL 

分 类 号：R735.8[医药卫生—肿瘤]