经内镜逆行胆胰管成像联合血清标志物对胆道良恶性肿瘤的诊断价值  

Diagnostic value of endoscopic retrograde cholangiopancreatography combined with serum markers in benign and malignant biliary tract tumors

作　　者：郭明浩[1] 王清踪 史鑫 杜杰 郭遂成[2] 赵付生[1] Guo Minghao;Wang Qingzong;Shi Xin;Du Jie;Guo Suicheng;Zhao Fusheng(Department of General Surgery,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China;Department of Gastroenterology,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院普通外科,南阳473000 [2]南阳医学高等专科学校第一附属医院消化内科,南阳473000

出　　处：《中华实验外科杂志》2023年第9期1835-1838,共4页Chinese Journal of Experimental Surgery

基　　金：南阳市科技攻关项目(KJGG073)。

摘　　要：目的探讨经内镜逆行胆胰管成像(ERCP)联合血清标志物对胆道良恶性肿瘤的诊断价值。方法选取2020年3月至2022年3月南阳医学高等专科学校第一附属医院收治的159例疑似胆道恶性肿瘤患者作为研究对象,所有患者经手术和病理证实为胆道恶性肿瘤的患者75例,胆道良性肿瘤患者35例,其他胆道疾病患者49例。采用糖类抗原CA19-9(CA19-9)、癌胚抗原(CEA)电化学发光法检测试剂盒检测所有患者血清CA19-9、CEA水平。比较ERCP检查在胆道良恶性肿瘤中的诊断价值。比较ERCP联合血清标志物CA19-9、CEA在胆道良恶性肿瘤的检出率。组间比较采用t检验。结果胆道恶性肿瘤患者血清中CA19-9和CEA水平[(229.04±129.01)U/ml、(23.34±14.47)ng/ml]明显高于胆道良性肿瘤患者[(83.19±47.42)U/ml、(5.90±1.75)ng/ml]和其他胆道疾病患者[(23.51±9.41)U/ml、(3.34±1.28)ng/ml],差异有统计学意义(t=6.474,P<0.05;t=11.12,P<0.05;t=7.086,P<0.05;t=9.636,P<0.05)。ERCP对胆道恶性肿瘤(86.67%)诊断的灵敏度明显高于胆道良性肿瘤(74.29%),对胆道恶性肿瘤(13.33%)诊断的漏诊率明显低于胆道良性肿瘤(25.71%),差异有统计学意义(t=5.383,P<0.05)。ERCP联合血清标志物CA19-9和CEA(91.43%)对胆道良性肿瘤检出率明显高于CA19-9和CEA的联合检出率(74.29%),差异有统计学意义(t=12.670,P<0.05)。ERCP联合血清标志物CA19-9和CEA(97.33%)对胆道恶性肿瘤检出率明显高于CA19-9和CEA的联合检出率(86.67%),差异有统计学意义(t=6.793,P<0.05)。结论ERCP联合血清标志物CA19-9和CEA可显著提高胆道良恶性肿瘤诊断的灵敏度、特异性和准确率。Objective To investigate the diagnostic value of endoscopic retrograde cholangiopancreatography(ERCP)combined with serum markers in benign and malignant biliary tract tumors.Methods A total of 159 patients with suspected biliary tract cancer admitted to our hospital from March 2020 to March 2022 were selected as the study objects.All patients were confirmed by surgery and pathology as malignant tumor of biliary tract in 75 cases,benign tumor of biliary tract in 35 cases,and other biliary diseases in 49 cases.The serum cancer antigen 19-9(CA19-9)and carcinoembryonic antigen(CEA)of all patients were detected with the CA19-9 and CEA electrochemiluminescence detection kit.The diagnostic value of ERCP examination in benign and malignant tumors of the biliary tract was compared.The detection rate of ERCP combined with serum markers CA19-9 and CEA in benign and malignant biliary tumors was compared.Comparison between groups was done using t-test.Results Serum concentrations of CA19-9 and CEA[(229.04±129.01)U/ml,(23.34±14.47)ng/ml]in patients with biliary malignant tumor were significantly higher than those in patients with biliary benign tumor[(83.19±47.42)U/ml,(5.90±1.75)ng/ml]and patients with other biliary diseases[(23.51±9.41)U/ml,(3.34±1.28)ng/ml,t=6.474,P<0.05;t=11.12,P<0.05;t=7.086,P<0.05;t=9.636,P<0.05].The sensitivity of ERCP in the diagnosis of biliary malignant tumor(86.67%)was significantly higher than that of biliary benign tumors(74.29%),and the missed diagnosis rate of ERCP in the diagnosis of biliary malignant tumor(13.33%)was significantly lower than that of biliary benign tumors(25.71%,t=5.383,P<0.05).The detection rate of ERCP combined with serum markers CA19-9 and CEA(91.43%)was significantly higher than that of CA19-9 combined with CEA(74.29%)for biliary benign tumors(t=12.670,P<0.05).The detection rate of ERCP combined with serum markers CA19-9 and CEA(97.33%)was significantly higher than that of CA19-9 combined with CEA(86.67%)for biliary malignant tumor(t=6.793,P<0.05).Conclusion The combin

关 键 词：经内镜逆行胆胰管成像 糖类抗原CA19-9 癌胚抗原 胆道癌 

分 类 号：R735.8[医药卫生—肿瘤]