血清糖链抗原19-9对梗阻性黄疸患者发生急性胆管炎的预测价值

潘亚军; 孙少甫

doi:10.3969/j.issn.1001-5256.2016.08.024

血清糖链抗原19-9对梗阻性黄疸患者发生急性胆管炎的预测价值

DOI: 10.3969/j.issn.1001-5256.2016.08.024

海口市第四人民医院普外科

基金项目:

海南省普通医学科研项目(2013-031)；

详细信息

中图分类号: R657.45
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出版历程
- 收稿日期: 2016-03-03
- 出版日期: 2016-08-20

Predictive value of serum CA19-9 in predicting acute cholangitis in patients with obstructive jaundice

Department of General Surgery,The Fourth People's Hospital of Haikou

Research funding:

摘要

摘要: 目的探讨梗阻性黄疸患者发生急性胆管炎的预测因子。方法回顾性分析海口市第四人民医院2010年10月-2015年10月收治的358例胆总管结石合并梗阻性黄疸患者的临床资料。根据患者是否发生急性胆管炎,分为急性胆管炎组（n=223）和梗阻性黄疸组（n=135）。比较两组患者的年龄、性别和合并症,评估血清肿瘤标志物及肝功能指标的异常与急性胆管炎发生的关系。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。选取有统计学意义的指标构建受试者工作特征曲线（ROC）,评价其对急性胆管炎诊断的敏感度和特异度。结果急性胆管炎组血清糖链抗原（CA）19-9、CA12-5水平明显高于梗阻性黄疸组[（82.33±23.01）k U/L vs（36.75±12.58）k U/L,（30.21±9.59）k U/L vs（18.62±5.27）k U/L],差异均有统计学意义（t值分别为11.028、8.597,P值均<0.001）。ROC曲线分析显示,血清CA19-9、CA12-5曲线下面积分别为0.891、0.705,对应诊断准确度最高的临界值分别为61.01 k U/L、22.56 k U/L,...
- 黄疸,阻塞性 /
- 胆管炎 /
- CA-19-9抗原
Abstract: Objective To investigate the predictive factors for acute cholangitis in patients with obstructive jaundice. Methods A retrospective analysis was performed for the clinical data of 358 patients with common bile duct stones and obstructive jaundice who were treated in The Fourth People's Hospital of Haikou from October 2010 to October 2015. According to the presence or absence of acute cholangitis,the patients were divided into acute cholangitis group( n = 223) and obstructive jaundice group( n = 135). Age,sex,and comorbidities were compared between the two groups,and the association between abnormalities in serum tumor markers and liver function parameters and the development of acute cholangitis was examined. The parameters with statistical significance were used to establish the receiver operating characteristic( ROC) curves,and their sensitivity and specificity in the diagnosis of acute cholangitis were evaluated. The t test and χ2test were applied for comparison of continuous data and categorical data between groups,respectively. Results The acute cholangitis group had significantly higher serum levels of CA19- 9 and CA12- 5 than the obstructive jaundice group( serum level of CA19- 9: 82. 33 ± 23. 01 k U / L vs 36. 75 ± 12. 58 k U / L,t = 11. 028,P < 0. 05; serum level of CA125: 30. 21 ± 9. 59 k U / L vs 18. 62 ± 5. 27 k U / L,t = 8. 597,P <0. 05). The analysis of the ROC curves showed that the areas under the ROC curve for serum CA19- 9 and CA12- 5 were 0. 891 and0. 705,respectively,and the corresponding cut- off values for the highest diagnostic accuracy were 61. 01 k U / L and 22. 56 k U / L,respectively,with sensitivities of 82. 1% and 77. 6% and specificities of 79. 8% and 69. 5%. Conclusion Increased serum CA19- 9 level has a great value in predicting acute cholangitis in patients with common bile duct stones and obstructive jaundice.
- jaundice /
- obstructive /
- cholangitis

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参考文献(13)

[1]AO J,ZENG LW,CAI Z,et al.Clinical analysis of causes of death after percutaneous transhepatic choledochal drainage for acute obstructive suppurative cholangitis[J].Chin J Gen Surg,2015,24(8):1195-1197.(in Chinese)敖劲,曾令雯,蔡争,等.急性梗阻性化脓性胆管炎经皮肝穿刺胆道引流术后死亡原因分析[J].中国普通外科杂志,2015,24(8):1195-1197.

[2]KIRIYAMA S,TAKADA T,STRASBERG SM,et al.TG13 guidelines for diagnosis and severity grading of acute cholangitis(with videos)[J].J Hepatobiliary Pancreat Sci,2013,20(1):24-34.

[3]WEI L,WANG CQ,LIU Z.Safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography in very elderly patients(85 years or older)with common bile duct stones[J].J Clin Hepatol,2015,31(10):1637-1640.(in Chinese)韦璐,王长青,刘政.经内镜逆行胰胆管造影治疗85岁以上胆总管结石患者的效果观察[J].临床肝胆病杂志,2015,31(10):1637-1640.

[4]LIANG JR,SHI DH,ZHANG C,et al.Clinical value of endoscopic retrograde cholangiopancreaphy in elderly patients with common bile duct calculi and its safety[J].Clin J Med Offic,2015,43(3):270-273.(in Chinese)梁君蓉,石德红,张冲,等.高龄胆总管结石患者内镜逆行胰胆管造影治疗的临床价值及安全性[J].临床军医杂志,2015,43(3):270-273.

[5]MEI Y,PENG CJ,ZHU HJ,et al.Technical difficulties of laparoscopic common bile duct exploration and their countermeasures for patients with history of upper abdominal surgery[J].J Clin Hepatol,2014,30(8):768-771.(in Chinese)梅永,彭慈军,朱洪江,等.上腹部术后行腹腔镜胆总管探查术的难点与对策[J].临床肝胆病杂志,2014,30(8):768-771.

[6]YANG Y,LI JW,FAN YD,et al.Clinical efficacy of reoperation by laparoscopy and choledochoscopy for the treatment of extrahepatic bile duct stones[J].Chin J Digest Surg,2014,13(2):139-141.(in Chinese)杨勇,李建伟,范毓东,等.腹腔镜联合胆道镜行胆道再手术治疗肝外胆管结石的临床疗效[J].中华消化外科杂志,2014,13(2):139-141.

[7]CHAN DS,JAIN PA,KHALIFA A,et al.Laparoscopic common bile duct exploration[J].Br J Surg,2014,101(11):1448-1452.

[8]MEI Y,PENG CJ,CHEN L,et al.Early detective value of serum CA19-9 levels for concomitant acute cholangitis in obstructive jaundice[J].Chin J Pract Surg,2015,35(4):445-447.(in Chinese)梅永,彭慈军,陈丽,等.血清CA19-9早期预判梗阻性黄疸发生急性胆管炎临床价值研究[J].中国实用外科杂志,2015,35(4):445-447.

[9]ALUBAIDI GH,ALI ZA,MAHMOOD AR.Detection of carbohydrate antigen CA199 levels in sera and tissues'homogenate of breast and thyroid benign cases[J].Iraqi J Pharm Sci,2010,19(1):62-64.

[10]KODAMA T,SATOH H,ISHIKAWA H,et al.Serum levels of CA199 in patients with nonmalignant respiratory diseases[J].JClin Lab Anal,2007,21(2):103-106.

[11]MARRELLI D,CARUSO S,PEDRAZZANI C,et al.CA199 serum levels in obstructive jaundice:clinical value in benign and malignant conditions[J].Am J Surg,2009,198(3):333-339.

[12]YANG TW,HE P.Relation of serum CA19-9 and CEA levels with inflammation in patients with cholelithiasis[J].Chongqing Med,2013,42(6):633-634.(in Chinese)杨天文,何平.胆结石患者血清CA19-9、CEA表达与胆管炎症的关系[J].重庆医学,2013,42(6):633-634.

[13]SHEEN-CHEN SM,SUN CK,LIU YW,et al.Extremely elevated CA19-9 in acute cholangitis[J].Dig Dis Sci,2007,52(11):3140-3142.

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