摘要
目的 探讨血清CA199在良恶性胆道疾病中表达的意义.方法 回顾性分析我院消化内科2010～2012年188例胆总管结石患者和49例肝外胆管癌伴阻塞性黄疸患者的住院病历资料,采用SPSS 1统计软件分析各患者血清CA199、肝功能等指标.结果 ①188例胆总管结石患者血清CA199阳性率达43.6％,阳性患者中CA199在37～ 200U/ml例数最多;49例肝外胆管癌患者血清CA199阳性率达91.8％,明显高于良性胆道疾病,差异有统计学意义（x2=16.94,P=0.00）;②胆总管结石伴阻塞性黄疸和肝外胆管癌患者不同血清胆红素水平的血清CA199表达水平有显著差异（P＜0.05）,血清CA199与总胆红素有密切的相关性,少数胆总管结石伴阻塞性黄疸患者血清CA199升高显著,但良恶性阻塞性黄疸患者之间血清CA199仍有显著性差异.③胆总管结石伴阻塞性黄疸患者经内镜逆行胰胆管造影术（endoscopic retrograde cholangiopancreatography,ERCP）治疗后2周,血清CA199、血清总胆红素较术前明显下降,差异有统计学意义（P＜0.05）.结论 血清CA199不仅可以运用于胆道恶性肿瘤的辅助诊断,也可以作为部分良性胆道疾病患者临床疗效的辅助观察指标之一.
Abstract： Objective To evaluate the clinical significance of serum CA199 in benign and malign biliary tract disease. Methods The article retrospectively analysed the hospital medical records of 188 patients with choledocholithiasis and 49 pa- tients with extrahepatic cholangiocarcinoma, and statistically analysed the serum CA199 ,index of liver function and other indica- tors with SPSS 13. Results （~）The positive rates of the serum CA199 reached 43.6% in 188 patients with eholedocholithiasis, and the majority levels of CA199 was between 37U/ml and 200U/nil ; The positive rates of the serum CA199 reached 91.8% in 49 patients with extrahepatic cholangiocareinoma, there was significantly higher than the positive rates of the serum CA199 in benign biliary tract disease （X2 = 16.94, P = 0.00 ） ; （~）There was a significant difference of serum CA199 expression （P 〈 0.05 ） between the different levels of serum bilirubin of the choledoeholithiasis with obstructive jundice and extrahepatie cholangiocar- cinoma patients. The serum CA199 and total bilirubin are closely related. Though a small number of choledocholithiasis with obstruction jaundice patients＇ serum CA199 increased significantly ,there was a significant difference of serum CA199 between benign and malignant obstructive jaundice patients. （~）There was a significant difference of serum CA199 and total bilirubin be- tween before and two weeks after endoscopic retrograde cholangiopancreatography （ERCP） in patients with choledocholithiasis with obstructive jundice（P 〈 0.05 ）. Conclusion The serum CA199 not only in the diagnosis of malignant biliary tract disease has important value,but also has important value to evaluate the clinical efficacy in benign biliary tract disease.
出处
《临床消化病杂志》
2013年第6期327-329,共3页
Chinese Journal of Clinical Gastroenterology
关键词
血清CA199
胆总管结石
肝外胆管癌
Serum CA199
Choledocholithiasis
Extrahepatic cholangiocarcinoma
