胆管刷检细胞学及K-Ras基因突变检测在恶性胆管梗阻早期定性诊断中的价值  

The value of bile duct brush cytology and K-Ras gene mutation detection in early qualitative diagnosis of malignant bile duct obstruction

作　　者：许颖颖[1] 王倩倩 秦耿[1] 房龙[1] XU Ying-ying;WANG Qian-qian;QIN Geng(Department of Gastroenterology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院消化内科,北京100029 [2]北京大学医学部中日友好临床医学院,北京100029

出　　处：《中日友好医院学报》2022年第5期259-262,271,共5页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨胆管刷检细胞学、K-Ras基因突变检测在恶性胆管梗阻早期定性诊断中的价值。方法:2021年1月—12月,对89例胆管梗阻患者进行胆管刷检、K-Ras基因突变检测,以病理学及随访结局为金标准,对2种诊断方法单独及联合检测诊断恶性胆管梗阻的灵敏度、特异度、准确率进行评价和比较。结果:胆管刷检细胞学诊断恶性胆管梗阻的灵敏度、特异度、准确率分别为52.6%(30/57)、96.9%(31/32)、68.5%(61/89),K-Ras基因突变的诊断结果分别为60.8%(31/51)、100%(32/32)、75.9%(63/83),而两者联合检测后,灵敏度可提高至72.5%(37/51),准确率可提高至81.9%(68/83),与胆管刷检细胞学检测比较,差异均有统计学意义(P<0.05)。结论:胆管刷检细胞学与K-Ras基因突变联合检测有助于恶性胆管梗阻的早期定性诊断。Objective:To investigate the value of bile duct brush cytology and K-Ras gene mutation detection in the early qualitative diagnosis of malignant bile duct obstruction.Methods:From January 2021 to December 2021,89 patients with bile duct obstruction underwent bile duct brushing and K-Ras gene mutation detection.The sensitivity,specificity,and accuracy rate of the two diagnostic methods alone or in combination were evaluated and compared.Results:The sensitivity,specificity,and accuracy rates of bile duct brush cytology in the diagnosis of malignant bile duct obstruction were 52.6%(30/57),96.9%(31/32),and 68.5%(61/89),respectively;and the diagnostic results of K-Ras gene mutation were 60.8%(31/51),100%(32/32),and 75.9%(63/83),respectively.After combined with detection,the sensitivity increased to 72.5%(37/51),and the accuracy increased to 81.9%(68/83),there were significant differences compared with bile duct brush cytology(P<0.05).Conclusion:The combined detection of bile duct brush cytology and K-Ras gene mutation is helpful for the early qualitative diagnosis of malignant bile duct obstruction.

关 键 词：恶性胆管梗阻 定性诊断 胆管刷检细胞学 K-RAS基因突变 灵敏度 

分 类 号：R735.3[医药卫生—肿瘤]