摘要
目的:探讨SpyGlass直视化系统(以下简称SpyGlass)联合肿瘤标志物糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原125(CA125)对恶性胆管狭窄的鉴别价值。方法:回顾性分析2020年8月至2022年7月广西医科大学第一附属医院收治的19例胆管狭窄患者的临床资料,均行SpyGlass检查和血清肿瘤标志物检测。采用受试者工作特征(ROC)曲线分析SpyGlass和血清肿瘤标志物对恶性胆管狭窄的诊断效能。结果:19例胆管狭窄中,良性胆管狭窄10例,恶性胆管狭窄9例。SpyGlass诊断恶性胆管狭窄的灵敏度为88.9%,特异度为80.0%,阳性预测值为80.0%,阴性预测值为88.9%,准确率为84.2%,ROC曲线下面积(AUC)为0.826;血清CA19-9诊断恶性胆管狭窄的灵敏度为100.0%,特异度为70.0%,AUC为0.889,高于AFP的0.625、CEA的0.694及CA125的0.764。SpyGlass联合CA19-9检测,平行法灵敏度为100.0%,系列法特异度为100.0%。结论:SpyGlass联合血清CA19-9可提高恶性胆管狭窄的诊断效能。
Objective:To explore the value of SpyGlass direct visualization system(SpyGlass)combined with tumor biomakers carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP)and carbohydrate antigen 125(CA125)in the diagnosis of maglinant bile duct stricture.Methods:The clinical data of nineteen cases of patients with bile duct stricture admitted to The First Affiliated Hospital of Guangxi Medical University from August 2020 to July 2022 were retrospectively analyzed,and underwent SpyGlass test as well as serum tumor marker detection.The value of SpyGlass and serum tumor markers in the diagnosis of malignant bile duct stricture was analyzed by receiver operating characteristic(ROC)curve.Results:Among the nineteen cases of bile duct stricture,there were ten benign cases and nine malignant cases.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under ROC curve(AUC)of Spy-Glass in the diagnosis of malignant bile duct stricture were 88.9%,80.0%,80.0%,88.9%,84.2%,and 0.826,respectively.Meanwhile,the sensitivity and specificity of serum CA19-9 in the diagnosis of malignant bile duct stricture were 100.0%and 70.0%,respectively;AUC was 0.889,higher than that of AFP 0.625,CEA 0.694 and CA1250.764.When SpyGlass was combined with CA19-9 detection,both the sensitivity of parallel method and the specificity of series method were 100.0%.Conclusion:SpyGlass combined with serum CA19-9 can improve the diagnostic value of malignant bile duct stricture.
作者
邝文熙
岑瑜
谢春晓
卢洁霞
姜海行
覃山羽
Kuang Wenxi;Cen Yu;Xie Chunxiao;Lu Jiexia;Jiang Haixing;Qin Shanyu(Department of Gastroenterology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《广西医科大学学报》
CAS
2023年第3期492-496,共5页
Journal of Guangxi Medical University
基金
国家自然科学基金资助项目(No.81960439)
广西自然科学特色创新团队专项基金(No.YYZS2020007)
