血清hs—CRP和CA19—9联合检测对良恶性胆囊疾病鉴别诊断的意义

目的探讨血清超敏C反应蛋白（hs-CRP）和糖类抗原CA19．9联合检测在良恶性胆囊疾病鉴别诊断中的临床意义。方法选择80例胆囊癌患者、100例胆囊良性疾病患者及126例健康正常人，分别应用免疫比浊法和电化学发光法测定血清hs-CRP和CA19-9含量。结果单独检测胆囊癌患者血清hs—CRP含量的敏感性为82．5％，特异性为68％，单独检测血清CA19—9含量的敏感性为70％，特异性为87％；以hs．CRP和CA19．9任意一项作为阳性指标，敏感性上升为96．25％，而二者均阳性对胆囊癌诊断的特异性上升为91％。结论血清CA19-9检测是胆囊癌诊断较理想的指标，血清hs．CRP和CA19．9联合检测对胆囊癌诊断有互补作用，对良恶性胆囊疾病的鉴别诊断有重要价值。

Objective To investigate the clinical significance of combined detection of serum hypersensitive C-reactive protein （ hs-CRP ） and carbohydrate antigen CA19-9 in the differential diagnosis of benign and malignant gallbladder disease. Methods 80 gallbladder cancer patients, 100 patients with benign disease and 126 healthy controls were chosen. The serum levels of hs-CRP in all studies were detected with immune turbidimetry and the serum levels of CA19-9 in all studies were detected by electrochemical luminescence. Results The sensitivity of separate detection of serum hs-CRP in gallbladder cancer patients was 82.5%, and the specificity was 68%. The sensitivity of separate detection of serum CA19-9 in gallbladder cancer patients was 70%, and the specificity was 87%. However when either hs -CRP or CA19-9 was used as a positive indicator of any one, the sensitivity increased to 96.25% and when both of them being positive was used as an indicator, the specificity increased to 91%. Conclusions Serum CA19-9 level is a better indicator of diagnosis of gallbladder cancer. The combined detection of serum hs-CRP and CA19-9 plays a complementary role in the diagnosis of gallbladder cancer and plays an important role in differential diagnosis of benign and malignant gallbladder disease.