血清和胆汁中Survivin蛋白水平对阻塞性黄疸的诊断价值

Diagnostic value of serum and bile survivin levels in obstructive jaundice

目的 :探讨血清和胆汁中Survivin水平是否可以区分恶性阻塞性黄疸(胆管癌)和良性阻塞性黄疸。方法:通过ELISA方法检测93例阻塞性黄疸患者和9例对照患者的血清和胆汁中Survivin表达水平,并通过ROC曲线分析其对阻塞性黄疸的诊断价值。结果:胆管癌胆汁中的平均Survivin浓度明显高于胆石症组、良性狭窄组、压迫性狭窄组及对正常照组(P<0.05)。而在血清中,胆管癌的平均Survivin浓度仅高于对照组(P=0.009)。ROC曲线分析显示,胆汁Survivin曲线下面积(AUC)为0.780(P<0.001),此时最优截断值为772.28 pg/mL,敏感度和特异度分别为67.27%和80.85%。但是对于血清Survivin,AUC仅为0.600(P=0.084)。结论:Survivin高表达于胆管癌患者胆汁中,胆汁Survivin水平可作为区分胆管癌和良性阻塞性黄疸的一个指标。

Objective： To detect the bile and serum survivin levels in patients with obstructive and to determine whether bile and/or serum survivin be helpful in distinguishing malignant obstructive jaundice （chotangiocarcinoma） from benign obstructive jaundice. Methods： Bile and serum survivin levels were determined using enzyme-linked immunosorbent assay. Receiver operating characteristic （ROC） curve was used to evaluate the feasibility of bile and/or serum in differentiating malig- nant obstructive jaundice from benign obstructive jaundice. Results： Mean bile survivin concentra- tions were significantly higher in cholangiocarcinoma compared to choledocholithiasis, benign biliary stricture, compressive stenosis and normal controts（P 〈 0.05, respectively）： However, only mean serum survivin concentrations were significantly higher in cholangiocarcinoma than normal controls（P=0.009）. For bile survivin, the area under the curve （AUC） was 0.780（P〈 0,001）, and the optimal cut-off value de-termined was 772.28 pg/mL, providing a sensitivity of 67.27 % and a specificity of 80.85 %. But the AUC was only 0.600 for serum survivin （P=0.084）. Conclusions These findings reveal that bile survivin is significantly increased in patients with cholangiocarcinoma, and bile survivin may be a useful indicator in differentiating distinguishinq cholangiocarcinoma from benign obstructive iaundice.