血清CA19-9、CA50和CEA表达水平与老年胆结石患者胆道炎症的关系  

Relationship between serum CA19-9,CA50 and CEA expression and biliary tract inflammation in elderly patients with cholecystolithiasis

作　　者：胡小丽[1] 刘哲[1] 邓茂林[2] 马欢[3] Hu Xiaoli;Liu Zhe;Deng Maolin;Ma Huan(Department of Gastroenterology,Affiliated Hospital of Chengdu University,Chengdu,Sichuan,610081;Department o General Medicine,Affiliated Hospital of Chengdu University,Chengdu,Sichuan,610081,P.R.China;Department of Gastroenterology,Central Hospital of Mianyang City,Mianyang,Sichuan,621000,P.R.China)

机构地区：[1]成都大学附属医院消化内科,四川成都610081 [2]成都大学附属医院全科医学科,四川成都610081 [3]绵阳市中心医院消化内科,四川绵阳621000

出　　处：《老年医学与保健》2020年第5期843-846,共4页Geriatrics & Health Care

基　　金：四川省卫生和计划生育委员会科研课题(18PJ395)。

摘　　要：目的探析血清糖类抗原19-9(CA19-9)、糖类抗原50(CA50)和癌胚抗原(CEA)在胆囊结石中的临床意义及其与胆道炎症的关系。方法回顾性分析2018年3月-2020年3月于成都大学附属医院消化内科收治的112例胆结石老年患者(观察组)的临床资料,另选取同期本院体检的40例健康者作为对照组。根据胆道炎症程度将观察组分为轻度亚组(n=38)、中度亚组(n=51)及重度亚组(n=23)。评估并比较各组血清CA19-9、CA50和CEA水平,分析其诊断的效能,并分析胆道炎症程度与血清CA19-9、CA50和CEA水平的相关性。结果观察组血清CA19-9、CA50和CEA水平均明显高于对照组(P<0.05);ROC曲线分析显示,血清CA19-9、CA50和CEA水平联合诊断胆结石的ROC曲线下面积明显大于单独指标诊断(P<0.05)。重度亚组术前血清CA19-9、CA50和CEA水平均明显高于轻度亚组和中度亚组,中度亚组血清CA19-9、CA50和CEA水平均高于轻度亚组,差异均有统计学意义(P<0.05)。治疗后观察组血清CA19-9、CA50和CEA水平均低于治疗前(P<0.05)。Spearman相关性分析显示,胆道炎症程度与血清CA19-9、CA50和CEA水平呈正相关性(P<0.05)。结论老年胆结石患者血清CA19-9、CA50和CEA呈高表达水平,且随着胆道炎症严重程度的增加,血清CA19-9、CA50和CEA水平逐渐增加,3个指标联合应用对于胆结石诊断具有重要的临床意义。Objective To explore the clinical significance of serum carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 50(CA50)and carcinoembryonic antigen(CEA)in cholecystolithiasis and their relationship with biliary tract inflammation.Methods The clinical data of 112 elderly patients(observation group)with cholecystolithiasis admitted to the affiliated hospital of Chengdu University from March 2018 to March 2020 were retrospectively analyzed.In addition,40 healthy people who received physical examination in our hospital during the same period were selected as the control group.According to the degree of biliary tract inflammation,the patients of the observation group were divided into the mild group(n=38),the moderate group(n=51)and the severe group(n=23).The levels of serum CA19-9,CA50 and CEA were examined and compared among four groups,and the diagnostic efficacy was analyzed.The correlation between the degree of biliary inflammation and the levels of serum CA19-9,CA50 and CEA was analyzed.Results The levels of serum CA19-9,CA50 and CEA of the observation group were higher than those of the control group(P<0.05).The area under ROC curve of serum CA19-9,CA50 and CEA in the diagnosis of cholecystolithiasis was significantly larger than that of each single index(P<0.05).The preoperative levels of serum CA19-9,CA50 and CEA of the severe group were higher than those of the mild and moderate groups,and the above indexes of the moderate group were higher than those of the mild group(P<0.05).The levels of serum CA19-9,CA50 and CEA of the observation group after treatment were lower than those before treatment(P<0.05).Spearman correlation analysis showed that biliary tract inflammation was positively correlated with the levels of serum CA19-9,CA50 and CEA(P<0.05).Conclusion The levels of serum CA19-9,CA50 and CEA in elderly patients with cholecystolithiasis were high.As the severity of biliary tract inflammation increases,the levels of serum CA19-9,CA50 and CEA increase gradually.The combined application of the three indexe

关 键 词：老年 胆囊结石 糖类抗原19-9 糖类抗原50 癌胚抗原 胆道炎症 

分 类 号：R575.6[医药卫生—消化系统]