血清CA19-9检测对良恶性梗阻性黄疸的鉴别诊断价值

The Value of Differential Diagnosis by Serum CA19-9 between Benign and Malignant Jaundice

目的探讨血清CA19-9结合总胆红素检测在梗阻性黄疸良恶性鉴别诊断中的应用价值。方法选取血清CA19-9水平高于参考值的15例良性梗阻性黄疸患者和23例恶性梗阻性黄疸患者,动态监测上述患者血清CA19-9及总胆红素水平在治疗前后的变化,并探讨二者的相关性。结果良性梗阻性黄疸患者治疗后血清CA19-9水平较治疗前显著降低,差异有统计学意义(P<0.01);恶性梗阻性黄疸患者治疗前后血清CA19-9水平差异无统计学意义(P=0.067)。治疗前及治疗后良性梗阻性黄疸患者血清CA19-9水平与血清总胆红素水平均呈正相关(r值分别为0.92和0.87,P均<0.01),而恶性梗阻性黄疸患者治疗前及治疗后二者均无相关性(r值分别为0.12和0.02,P值分别为0.64和0.83)。结论利用良性梗阻性黄疸患者治疗前后CA19-9水平变化的显著差异,同时结合CA19-9与血清总胆红素呈正相关这一特征,临床上可用CA19-9结合总胆红素检测来鉴别高表达CA19-9梗阻性黄疸的良恶性。

Objective To explore the value of differential diagnosis by serum CA19-9 combinatied with serum total bilirubin to distinguish benign and malignant obstructive jaundice.Methods 15 cases of CA19-9 above the normal of benign obstructive jaundice and 23 patients with malignant obstructive jaundice patients were monitored by the serum CA19-9 and total bilirubin before and after treatment to inuestigate the correlation of the two indexs.Results Serum CA19-9 of patients with benign obstructive jaundice significantly decreased after treatment,the difference was significant（P0.01）;CA19-9 of patients with malignant obstructive jaundice was no significantly difference before and after treatment（P=0.067）.There was a positive correlation between the change of CA19-9 level and serum total bilirub in patients with benign obstructive jaundice before and after treatment（r=0.92 and 0.87,P0.01）.However,there was no correlation in the malignant group（r=0.12 and 0.02,P=0.64 and 0.83）.Conclusion Using CA19-9 levels of benign obstructive jaundice before and after treatment in patients with a significant difference,combined with positively correlation between CA19-9 and serum total bilirubin could distinguish benign from malignant obstructive jaundice.