梗阻性黄疸患者血清TSGF和CA19-9水平与其预后的相关性研究

Study on the correlation of serum CA19-9, TSGF levels and the prognosis of patients with obstructive jaundice

目的探讨肿瘤特异性生长因子(TSGF)和糖类肿瘤相关抗原(CA19-9)对梗阻性黄疸(obstructive jaundice,OJ)患者预后的影响。方法检测OJ患者和健康对照组血清TSGF和CA 19-9水平,采用t检验、x2检验等比较组间差异,分析其水平对患者预后的影响。结果 OJ患者TB、ALT、AST水平均明显高于对照组(P<0.05),且肿瘤性OJ与良性OJ间TB、ALT、AST水平均存在统计学差异(P<0.05);治疗后,肿瘤性OJ组的TB、ALT、AST水平较治疗前明显降低,但仍高于对照组(P<0.05);ALB变化与TB、ALT、AST相反。肿瘤性OJ组TSGF及CA 19-9阳性率均明显高于良性OJ组和对照组,良性OJ组TSGF及CA19-9阳性率均明显高于对照组(P<0.05)。阳性TSGF和CA 19-9均可使患者预后变差,二者均为阳性的患者3年累计生存率最低(P<0.05)。结论应重视梗阻性黄疸,及早进行规范治疗;如有条件推荐检测TSGF和CA 19-9水平,并采取措施阻止病情恶化,尽可能改善预后。

Objective To investigate the levels of the tumor specific growth factor （TSGF）, tumor-associatedcarbohydrate antigen （CA 19-9） in patients with obstructive jaundice （OJ） and analyze the correlation between serum CA19-9 and TSGF levels with prognosis of the OJ patients. Methods Serum TSGF and CA 19-9 levels of OJ patients and the control subjects were detected using rapid detection kit, and their impacts on the prognosis of OJ patients were analyzed. Results OJ patient＇s TB, ALT, AST levels were significantly higher than control subjects （P〈0.05）; after treatment, TB, ALT, AST levels of tumor OJ group were significantly lower than that treatment before, but still significantly higher than that of the control （P〈0.05）; ALB changed oppositely to TB, ALT, AST. The positive rates of TSGF and CA 19-9 in tumor OJ group were significantly higher than that of benign OJ group and control group, the positive rates of TSGF and CA 19-9 in benign OJ group were significantly higher than the control （P〈0.05）. Positive TSGF and CA 19-9 could make prognosis of OJ to be worse, the 3-year cumulative survival rate of patients with positive TSGF and positive CA 19-9 was lowest （P〈0.05）. Conclusion The treatment of obstructive jaundice should be more specificated, and be given early treatment. TSGF and CA 19-9 levels detection is recommended as early as possible for preventing disease progression, and to improve the therapeutic effect and prognosis.