MRI、MSCT及血清学检查在诊断肝门部胆管癌中的应用比较

Comparison of MRI,MSCT and Serological Examination for Diagnos is of Hilar Cholangiocarcinoma

目的探讨磁共振成像(MRI)、多层螺旋CT(MSCT)及血清学检查在诊断肝门部胆管癌(HCCA)中的应用价值。方法回顾性分析2013年2月~2019年2月本院收治的108例肝门部胆管病变患者临床资料,所有患者均行MRI、MSCT、血清学(糖类抗原199(CA199)、糖类抗原125(CA125)和癌胚抗原(CEA)检查,比较MRI、MSCT及血清学对HCCA、淋巴结转移情况的诊断效能。结果MRI+MSCT+血清学肿瘤标志物联合检查诊断HCCA的灵敏度、特异度、准确度为94.25%、85.71%、92.59%,较三者单独检查的灵敏度(88.00%、81.61%、80.46%)和准确度(77.69%、79.63%、79.63%)明显高,MRI+MSCT+血清学肿瘤标志物联合检查诊断HCCA患者淋巴结转移的灵敏度、特异度、准确度为90.91%、93.02%、91.95%,较三者单独检查的灵敏度(82.00%、86.36%、84.09%)、准确度(78.17%、79.31%、79.31%)明显高(P<0.05)。结论MRI+MSCT+血清学肿瘤标志物联合检查在HCCA患者术前诊断、淋巴结转移评估中有较高的诊断效能,影像学检查联合血清学肿瘤标志物检测或可作为HCCA的有效诊断方案。

Objective To investigate the value of magnetic resonance imaging(MRI),multi-slice spiral CT(MSCT)and serological examination in the diagnosis of hilar cholangiocarcinoma(HCCA).Methods The clinical data of 108 patients with HCCA admitted to the hospital from February 2013 to February 2019 were analyzed retrospectively.All patients underwent MRI,MSCT and examination of serological tumor markers[serum carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125)and carcinoembryonic antigen(CEA)].The diagnostic efficiencies of MRI,MSCT and serological examination for HCCA were evaluated and compared.Results The sensitivity,specificity and accuracy of MRI combined with MSCT and serological tumor markers for diagnosis of HCCA were 94.25%,85.71%and 92.59%.The sensitivity and accuracy were obviously higher than those of the three alone[(88.00%,81.61%,80.46%)and(77.69%,79.63%,79.63%)].The sensitivity,specificity and accuracy of MRI combined with MSCT and serological tumor markers for diagnosis of lymph node metastasis of HCCA were 90.91%,93.02%and 91.95%.The sensitivity and accuracy were obviously higher than those of the three alone[(82.00%,86.36%,84.09%)and(78.17%,79.31%,79.31%)](P<0.05).Conclusion Combined examination of MRI+MSCT+serological tumor markers has a high diagnostic efficacy in preoperative diagnosis and evaluation of lymph node metastasis in HCCA patients.Combined examination of imaging and serological tumor markers may be an effective diagnostic scheme for HCCA.