| 宋维通,王 坤,靳 晶,杨尚文,陆芳菲.磁共振胰胆管成像联合血清CA125、CA19-9、CEA对良恶性梗阻性黄疸的诊断价值[J].,2021,(8):1469-1473 |
| 磁共振胰胆管成像联合血清CA125、CA19-9、CEA对良恶性梗阻性黄疸的诊断价值 |
| Diagnostic Value of Magnetic Resonance Cholangiopancreatography Combined with Serum CA125, CA19-9 and CEA in Benign and Malignant Obstructive Jaundice |
| 投稿时间：2020-12-01 修订日期：2020-12-23 |
| DOI：10.13241/j.cnki.pmb.2021.08.015 |
| 中文关键词: 磁共振胰胆管成像 梗阻性黄疸 糖类抗原125 糖类抗原19-9 癌胚抗原 |
| 英文关键词: Magnetic resonance cholangiopancreatography Obstructive jaundice Carbohydrate antigen 125 Carbohydrate antigen 19-9 Carcinoembryonic antigen |
| 基金项目:江苏省自然科学基金项目（BK20161599） |
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| 中文摘要: |
| 摘要 目的：研究磁共振胰胆管成像（MRCP）联合血清糖类抗原125（CA125）、糖类抗原19-9（CA19-9）、癌胚抗原（CEA）对良恶性梗阻性黄疸的诊断价值。方法：将医院从2018年1月～2020年2月期间收治的90例良恶性梗阻性黄疸患者纳入研究。将其按照良恶性的差异分为良性梗阻性黄疸51例以及恶性梗阻性黄疸39例。分别对所有患者进行MRCP检测，并分析良恶性梗阻性黄疸MRCP影像学表现特征的差异。此外，采集所有患者清晨空腹静脉血，检测血清CA125、CA19-9、CEA水平并进行对比。通过受试者工作特征（ROC）曲线分析明确MRCP联合血清CA125、CA19-9、CEA对良恶性梗阻性黄疸的诊断价值。结果：恶性梗阻性黄疸部位为十二指肠乳头区人数占比明显高于良性梗阻性黄疸，而胰头上区、胰头区人数占比均明显低于良性梗阻性黄疸；且恶性梗阻性黄疸梗阻重度扩张人数占比明显高于良性梗阻性黄疸，而梗阻轻度扩张人数占比明显低于良性梗阻性黄疸，差异均有统计学意义（均P＜0.05）。恶性梗阻性黄疸患者血清CA125、CEA水平均明显高于良性梗阻性黄疸患者（均P＜0.05）；而两组血清CA19-9水平对比不明显（P＞0.05）。MRCP联合血清CA125、CA19-9、CEA诊断良恶性梗阻性黄疸的曲线下面积、灵敏度、特异度、约登指数均明显高于MRCP和血清CA125、CA19-9、CEA单独诊断。结论：MRCP联合血清CA125、CA19-9、CEA对良恶性梗阻性黄疸的诊断价值较高，值得临床推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To study the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) combined with serum carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) in benign and malignant obstructive jaundice. Methods: A total of 90 patients with benign and malignant obstructive jaundice who were admitted to our hospital from January 2018 to February 2020 were included in this study. According to the difference between benign and malignant, they were divided into benign obstructive jaundice with 51 cases and malignant obstructive jaundice with 39 cases. MRCP detection was performed on all subjects respectively, and the differences of MRCP imaging features between benign and malignant obstructive jaundice were analyzed. In addition, the morning fasting venous blood of all subjects was collected, and the levels of serum CA125, CA19-9 and CEA were detected and compared. The diagnostic value of MRCP combined with serum CA125, CA19-9 and CEA in benign and malignant obstructive jaundice was determined by receiver operating characteristic (ROC) curve analysis. Results: The proportion of patients with malignant obstructive jaundice in duodenal papilla area was significantly higher than that in benign obstructive jaundice, while the proportion of patients with upper pancreatic head area and pancreatic head area was significantly lower than that in benign obstructive jaundice. And the proportion of malignant obstructive jaundice with severe obstructive dilatation was significantly higher than that of benign obstructive jaundice, while the proportion of mild obstructive dilatation was significantly lower than that of benign obstructive jaundice, the differences were statistically significant (all P<0.05). The levels of serum CA125 and CEA in patients with malignant obstructive jaundice were significantly higher than those in patients with benign obstructive jaundice (all P<0.05). There was no significant difference in serum CA19-9 level between the two groups (P>0.05). The area under the curve, sensitivity, specificity and Youden index of MRCP combined with serum CA125, CA19-9 and CEA in the diagnosis of benign and malignant obstructive jaundice were significantly higher than those of MRCP and serum CA125, CA19-9 and CEA alone. Conclusion: MRCP combined with serum CA125, CA19-9 and CEA has a high diagnostic value in benign and malignant obstructive jaundice, which is worthy of clinical application. |
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