胆囊PCNA表达及胆汁淀粉酶测定的意义

The significance of proliferating cell nuclear antigen in gallbladder and amylase in bile

目的通过对胆囊切除术中患者胆囊增殖核抗原（proliferating cell nuclear antigen．PCNA）和胆汁淀粉酶测定，来探讨胰胆管合流异常的诊断。方法收集胆囊切除手术的胆囊及胆汁标本178例，进行PCNA染色，淀粉酶测定及MRCP检查。结果178例标本中，胆汁淀粉酶正常的142例，升高的36例。PCNA表达，178例中阳性的46例，其中升高组中25例（14．04％），正常组中21例（11．80％）。阴性132例，升高组中11例（6．18％），正常组中121例（67．98％）。升高组中36例病人21例病人行MRCP检查，发现3例胰胆管全流异常（anomalous pancreaticobiliary ductal union．APBDU）。正常组中142例病人51例行MRCP检查，未发现APBDU。结论胆汁淀粉酶升高的病人提示有胰液的返流，可能是由APBDU引起，应进一步检查以排除APBDU。

Objective To investigate diagnosis of anomalous pancreaticobiliary ductal union through testing proliferating cell nuclear antigen in gallbladder and amylase in bile. Methods 178 cases of gallbladder and bile were studied by testing proliferating cell nuclear antigen histochemical and amylase. Results 142 cases of amylase in bile were found to be the normal and 36 cases were higher than the normal.46 of 178 cases were positive in proliferating cell nuclear antigen expression, which included 25 cases in higher group and 21 in the normal group. 132 cases were negative including 11 in higher group and 121 in the normal, 21 cases of 36 in higher group were tested by MRCP and 3 cases of APBDU were found. No case was found in 51 cases which tested by MRCP in 142 cases of the normal group. Conclusions The elevation of amylase in bile showed that the reflux of pancreatic juice into the bile duct occured, which may be caused by APBDU. More examination shoud be done to find APBDU.