梗阻性黄疸患者胆汁基质金属蛋白酶7、肿瘤标记物水平变化及其临床意义

Changes and clinical significance of patients with obstructive jaundice's biliary matrix metalloproteinase 7,tumor markers

目的研究梗阻性黄疸(OJ)患者胆汁基质金属蛋白酶7(MMP-7)、肿瘤标记物水平变化及其临床意义。方法选择2012年3月至2015年3月在我院接受治疗的从OJ患者200例作为研究对象,导致OJ恶性病因80例,导致OJ良性病因120例,分析不同时期(入院时及术后2周)OJ患者胆汁肿瘤标记物及MMP-7水平变化情况,评估CA19-9、CEA及MMP-7指标对OJ恶性肿瘤的诊断效果。结果恶性病因患者胆汁CA19-9及CEA水平均显著高于良性病因患者(F=4.542,P=0.030)。恶性病因组内CA19-9及CEA水平差异无统计学意义(F=1.259,P=0.063),恶性病因组内术后2周的CA19-9及CEA水平均分别显著低于入院时的水平,(均P<0.05)。恶性病因患者组内的MMP-7水平差异无统计学意义(F=0.833,P=0.123),但恶性病因组内术后2周MMP-7水平均分别显著低于入院时的水平(均P<0.05)。胆汁CA19-9、CEA及MMP-7指标联合检测的敏感性、特异性及准确度均最高。结论 OJ患者胆汁MMP-7及肿瘤标记物CA19-9及CEA水平的变化对临床病情具有较大的显示价值,三者联合检测,可以更加准确地诊断患者病情。

Objective To study changes and clinical significance of patients with obstructive jaundice＇s（OJ）biliary matrix metalloproteinase 7,tumor markers.Method Selected 2012 March to 2015 March treated in our hospital of200 cases of patients as the research object.Malignant etiology of lead to OJ had 80 cases,benign etiology of lead to OJ had 120 cases,analysis of different periods（2weeks at the time of admission and postoperative changes of OJ）of bile in patients with tumor markers,changes of bile MMP-7,CA19-9,CEA levels in patients with OJ,analysis and diagnosis effect of bile and the index of MMP-7,OJ in malignant tumor.Result Malignant causes of bile in patients with OJ＇s CA19-9and CEA levels were significantly higher than benign causes of those levels,the difference was statistically significant（F=4.542,P=0.030）.Compared with the malignant etiology group within the CA19-9and CEA levels,had no significant difference（F=1.259,P=0.063）,but the malignant etiology group 2weeks after operation＇s CA19-9and CEA levels were significantly lower than the level at admission,and there were statistical significant differences（P〈0.05）.Compared to OJ patients in the group＇s MMP-7level of malignant causes,there were no statistical significantly differences（F=0.833,P=0.123）.But the malignant etiology group 2weeks after operation＇s MMP-7water was significantly lower than the average level at admission,there were statistical significantly differences（P〈0.05）.CA19-9,CEA and MMP-7index of bile combined detection sensitivity,specificity and accuracy were the highest.Conclusion The changes of OJ in patients with bile tumor markers CA19-9and CEA and MMP-7having a display value larger on the clinical condition of the patient,by combined detection of the three,can more accurately diagnose patients,the effect is good,worthy of attention.