十二指肠乳头肿瘤患者的临床特征分析及其对肿瘤进展期的诊断价值  

Analysis of clinical characteristics of patients with duodenal papilla neoplasms and the diagnostic value for advanced carcinoma

作　　者：乔新伟 邱煜婷 李鹏[1] 吴静[1] 张澍田[1] Qiao Xinwei;Qiu Yuting;Li Peng;Wu Jing;Zhang Shutian(Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,National Clinical Research Center for Digestive Diseases,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院消化内科,国家消化系统疾病临床医学研究中心,北京100050

出　　处：《首都医科大学学报》2023年第6期990-998,共9页Journal of Capital Medical University

基　　金：北京市医院管理中心消化内科学科协同发展中心重点项目(XXZ015);首都临床诊疗技术研究及转化应用项目(Z211100002921028);首都卫生发展科研专项项目(CFH2022-2-2025);北京市通州区科技计划项目(KJ2023CX016)。

摘　　要：目的本研究旨在探索对鉴别诊断十二指肠乳头肿瘤(duodenal papilla neoplasms,DPNs)早癌与进展期癌有价值的临床指标。方法纳入95例DPNs患者的一般情况、实验室化验以及包括消化内镜等影像学检查的数据,通过LASSO(least absolute shrinkage and selection operator)回归初步筛选预测因素,再通过单因素及多因素Logistic分析确定进展期DPNs的独立危险因素。结果对本研究中的95例DPNs患者,采用LASSO回归筛选出症状、糖类抗原125(carbohydrate antigen 125,CA125)、CA50、γ-谷氨酰基转移酶(γ-glutamyltransferase,GGT)、总胆红素(total bilirubin,TBIL)、血红蛋白(hemoglobin,Hb)等6项指标进行Logistic回归分析,最终确定出现临床症状、GGT以及CA50升高这3项指标是DPNs进入进展期的独立预测因素(P<0.05)。结论出现黄疸等临床症状以及GGT、CA50明显升高可能是比影像学检查更有价值的诊断进展期DPNs的独立危险因素。Objective To explore valuable indicators for the differential diagnosis of early and advanced duodenal papilla neoplasms(DPNs).Methods Data of general conditions,laboratory tests and imaging examinations including digestive endoscopy were collected from patients with DPNs.LASSO(least absolute shrinkage and selection operator)regression was used to screen predictive factors.Univariate and multivariate Logistic analysis were used to determine the independent risk factors for advanced DPNs.Results A total of 95 DPNs patients were included in this study.Symptoms,carbohydrate antigen 125(CA125),CA50,γ-glutamyltransferase(GGT),total bilirubin(TBIL)and hemoglobin(Hb)were screened out by LASSO regression for Logistic regression analysis.Finally,clinical symptoms,elevated GGT and CA50 were validated to be independent predictors of progressive DPNs(P<0.05).Conclusion The clinical symptoms such as jaundice,significantly increased GGT and CA50 are independent risk factors,and it may be more valuable than imaging examination in the judgment of DPNs as advanced carcinoma.

关 键 词：十二指肠乳头肿瘤 肿瘤标志物 进展期癌 早癌 

分 类 号：R574[医药卫生—消化系统]