血清GGT,GGT/ALP及CA19-9检测在恶性梗阻性黄疸诊断中的价值

Clinical diagnosis value of combined detection of GGT,GGT/ALP ratio and CA19-9 in patients with malignant obstructive jaundice

目的:探讨血清γ-谷氨酰转移酶(GGT)、γ-谷氨酰转移酶/碱性磷酸酶(GGT/ALP)及糖类相关抗原199(CA19-9)对恶性梗阻性黄疸的临床诊断价值.方法:回顾性分析我院2002-07/2007-07收治的366例梗阻性黄疸患者的临床资料,根据临床诊断分成恶性梗阻性黄疸组、结石伴炎性梗阻性黄疸组及结石不伴炎性梗阻性黄疸组3组;同时选择健康志愿者40例作为正常对照组.术前采用放射免疫法检测血清中CA19-9水平,采用全自动生化仪检测血清GGT和ALP水平.结果:梗阻性黄疸各组各指标均显著高于正常对照组(P<0.05);在梗阻性黄疸病例中,恶性梗阻性黄疸组GGT,CA19-9水平显著高于结石性梗阻性黄疸组(P<0.05),恶性梗阻性黄疸组GGT/ALP比值显著低于结石性梗阻性黄疸组(P<0.05);结石伴炎性梗阻性黄疸组GGT水平显著高于结石不伴炎性梗阻性黄疸组(P<0.05),两组间CA19-9水平及GGT/ALP比值无统计学差异(P>0.05);GGT和CA19-9单独检测对恶性梗阻性黄疸的诊断率分别为81.56%和72.63%,GGT联合CA19-9检测对恶性梗阻性黄疸的诊断率为92.74%,GGT联合CA19-9检测对恶性梗阻性黄疸的诊断率显著高于GGT及CA19-9单独检测(P<0.05).结论:血清GGT,GGT/ALP及CA19-9检测可辅助良、恶性梗阻性黄疸的鉴别诊断,GGT联合CA19-9检测能够提高恶性梗阻性黄疸的诊断率.

AIM：To evaluate the diagnostic value of combined detection of serum GGT,GGT/ALP ratio and CA19-9 in patients with malignant obstructive jaundice.METHODS：A total of 366 patients diagnosed as obstructive jaundice in our hospital from July 2002 to July 2007 were included in this retrospective study.All the study objects were divided into 3 groups according to the clinical diagnosis：Neoplastic obstructive jaundice group,biliary calculi with inflammation obstructive jaundice group and biliary calculi without inflammation obstructive jaundice group.Forty healthy volunteers were recognized as control group.Serum CA19-9 levels was determined by radioimmunoassay,srum GGT and ALP levels were determined by absorption spectrometry.RESULTS：There are significant differences in the levels of GGT,GGT/ALP and CA19-9 between control group and the obstructive jaundice groups（P0.05）;In the obstructive jaundice groups the levels of GGT and CA19-9 were significantly higher in neoplastic obstructive jaundice group than the biliary calculi obstructive jaundice groups（P0.05）,but the levels of GGT/ALP were significantly lower in neoplastic obstructive jaundice group（P0.05）;the levels of GGT were significantly higher in biliary calculi with inflammation obstructive jaundice group than biliary calculi without inflammation obstructive jaundice group（P0.05）,but no significant differences in the levels of GGT/ALP and CA19-9 were found between the two groups（P0.05）.The diagnosis rates of neoplastic obstructive jaundice using GGT,CA19-9 and the combined detection were 81.56%,72.63% and 92.74%,respectively.The diagnosis rates of combined detection were significantly higher than using GGT or CA19-9 separately（P0.05）.CONCLUSION：The detection of GGT,GGT/ALP and CA19-9 can assist the identification of benign and malignant obstructive jaundice.The combined detection can improve the diagnosis rate of neoplastic obstructive jaundice.