胆囊癌中胆汁淀粉酶增高的临床研究

Clinical research of biliary amylase level heighten for patients with gallbladder cancer

目的探讨胰胆逆流在胆囊癌早期诊断中的价值。方法对2007年6月至2010年3月北京军区总医院肝胆外科诊治93例胆囊癌的术前影像学资料、术中胆汁淀粉酶水平结合术中探查及手术结果进行综合分析,测定同期(随机抽取)43例行磁共振胰胆管成像(MRCP)检查胆囊结石病人胆汁淀粉酶水平。结果 93例术后病理均确诊为胆囊癌,胆汁淀粉酶为(356.3±296.4)U/L,其中62例胆汁淀粉酶明显高于血清淀粉酶正常上限;29例胰胆合流异常病人中27例胆汁淀粉酶明显高于血清淀粉酶正常上限。结论胆囊癌病人中胰胆逆流发生率较高,可能对胆囊癌的早期诊断具有重要的临床意义。

Objective To study the value of panereatieobiliary reflux in the preoperative diagnosis of patients with gallbladder cancer. Methods Ninety-three patients with gallbladder cancer were admitted from June 2007 to March 2010 at General Hospital of Chinese PLA Beijing Military Region. The information of imageology and the bile amylase level of cystic of 93 patients were detected, and compared with the intraoperative exploration findings and post-operative pathological diagnosis. The bile amylase levels of 43 conse-eutive patients with cholecystolithiasis were detected. Results The final diagnosis of all patients was carcinoma of gallbladder. The mean biliary amylase level of 93 patients was （356.3±296.4）U/L. The biliary amylase level was above that of normal serum in 6：2 patients. Preoperative 29 cases were diagnosed as anomalous pancreaticobiliary ductal union, and in 27 of them the biliary amylase level was above that of normal serum. Conclusion The incidence of panereatieobiliary reflux is higher in gallbladder cancer patients, which might play an important role in the early diagnosis of gallbladder cancer.