CT三维重建联合血清CA19-9、CEA检查用于肝门部胆管癌诊断和可切除性评估的价值  

The value of CT three-dimensional reconstruction combined with serum carbohydrate antigen 19-9 and carcinoembryonic antigen detection in the diagnosis and resectability evaluation of hilar cholangiocarcinoma

作　　者：朱静 张洪彬[1] Zhu Jing;Zhang Hongbin(Department of Radiology,Yiwu Central Hospital,Yiwu 322000,Zhejiang Province,China)

机构地区：[1]义乌市中心医院放射科,义乌322000

出　　处：《中国基层医药》2024年第3期327-332,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省金华市科学技术研究计划(2021-4-168)。

摘　　要：目的探讨CT三维重建联合糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)、癌胚抗原(carcinoembryonic antigen,CEA)对肝门部胆管癌可切除性淋巴结转移术前诊断和可切除性评估的价值。方法选取2019年6月至2022年6月于义乌市中心医院就诊的疑似肝门部胆管癌患者65例作为观察组,另选取同期体检的健康人30例为对照组。患者均给予CT三维重建检查,同时使用全自动电化学发光免疫分析仪检测血清CA19-9、CEA水平,以经皮肝穿刺胆管造影检查所得的结果为“金标准”,分析CT三维重建、CA19-9、CEA及三者联合检出肝门部胆管癌与“金标准”诊断结果的一致性,分析CT三维重建、CA19-9、CEA及三者联合对肝门部胆管癌的诊断价值。结果观察组血清CA19-9[(62.71±10.63)U/mL]、CEA[(62.71±10.63)ng/mL]均显著高于对照组[CA19-9(12.37±7.39)U/mL、CEA(1.31±0.97)ng/mL],差异均有统计学意义(t=23.43、11.59,均P<0.05);淋巴结转移的肝门部胆管癌患者CA19-9[(71.69±12.37)U/mL]、CEA[(8.89±3.51)ng/mL]均显著高于淋巴结未转移的肝门部胆管癌患者[CA19-9(56.78±10.16)U/mL、CEA(6.45±2.11)ng/mL],差异均有统计学意义(t=4.14、2.76,均P<0.05)。CT三维重建技术分型结果与组织病理学检查比较,其分型准确率为85.00%;与“金标准”诊断结果相比,CT三维重建、CA19-9、CEA及三者联合检出肝门部胆管癌分别为22例(55.00%)、26例(65.00%)、31例(77.50%)、38例(95.00%),且相比CT三维重建、CA19-9、CEA水平检查,三者联合检查肝门部胆管癌的检出率最高,差异均有统计学意义(χ^(2)=18.15,P<0.05);与CT三维重建(AUC值:0.808)、CA19-9(AUC值:0.721)、CEA(AUC值:0.703)单项检测相比,三者联合检测(AUC值:0.913)诊断价值较高,差异均有统计学意义(均P<0.05)。结论CT三维重建、CA19-9、CEA对肝门部胆管癌均有一定的诊断价值,但使用CT三维重建联合CA19-9、CEA对肝门部胆管癌患者进行诊断,其诊断价值更高,为临Objective To investigate the value of three-dimensional reconstruction combined with serum carbohydrate antigen 19-9(CA19-9)and carcinoembryonic antigen(CEA)detection in the diagnosis and resectability evaluation of hilar cholangiocarcinoma(HCCA)before resectable lymph node metastasis.Methods A total of 65 patients with suspected HCCA who were treated at Yiwu Central Hospital from June 2019 to June 2022 were included in the observation group.Thirty healthy people who concurrently underwent physical examinations in the same hospital were included in the control group.All participants underwent a CT three-dimensional reconstruction examination.Simultaneously,the automatic electrochemiluminescence immunoassay analyzer was used to measure serum levels of CA19-9 and CEA.The outcomes of percutaneous transhepatic cholangiography were used as the"gold standard".The consistency between CT three-dimensional reconstruction,CA19-9 detection,and CEA detection,either individually or combined,and the"gold standard"in the diagnosis of HCCA was evaluated.Results Serum levels of CA19-9 and CEA in the observation group were(62.71±10.63)U/mL and(62.71±10.63)ng/mL,respectively,which were significantly higher than those in the control group[(12.37±7.39)U/mL,(1.31±0.97)ng/mL,t=23.43,11.59,both P<0.05].The levels of CA19-9[(71.69±12.37)U/mL]and CEA[(8.89±3.51)ng/mL]in patients with HCCA who had lymph node metastasis were significantly higher than those in patients with HCCA who had no lymph node metastasis[CA19-9(56.78±10.16)U/mL,CEA(6.45±2.11)ng/mL,t=4.14,2.76,both P<0.05].Compared with histopathological examination,the accuracy of CT three-dimensional reconstruction in typing was 85.00%.According to the"gold standard"diagnosis,CT three-dimensional reconstruction,CA19-9 detection,and CEA detection,alone and their combination,successfully detected HCCA in 22 cases(55.00%),26 cases(65.00%),31 cases(77.50%),and 38 cases(95.00%),respectively.The detection rate of HCCA was the highest when CT three-dimensional reconstruction,CA19-9

关 键 词：胆管肿瘤 淋巴结 体层摄影术 螺旋计算机 成像 三维 癌胚抗原 

分 类 号：R735.8[医药卫生—肿瘤]