MRCP技术联合血清CEA、CA19-9及CA242检测在胆道恶性梗阻中的诊断价值

Value of MRCP Technology Combined Detection of Serum CEA,CA19-9 and CA242 in Diagnosis of Patients with Malignant Biliary Obstructive Diseases

目的分析磁共振胰胆管成像(MRCP)技术联合癌胚抗原(CEA)、癌抗原19-9(CA19-9)及CA242在胆道恶性梗阻诊断中的价值。方法选择2015年9月—2020年12月收治的胆道梗阻73例,分析病理诊断结果及MRCP特征;比较胆道良、恶性病变血清CEA、CA19-9及CA242水平,并分析MRCP联合上述因子对胆道恶性梗阻的诊断价值。结果73例胆道梗阻确诊为恶性32例,良性41例。胆道良性梗阻病变血清CEA、CA19-9及CA242水平及阳性表达率均低于胆道恶性梗阻病变(P<0.01)。MRCP可见梗阻端胆管阻断、双管征、圆钝乳头状等特征,梗阻水平以上胆管多呈重度扩张。CEA、CA19-9、CA242及MRCP联合检测曲线下面积更大。结论胆道恶性梗阻患者CEA、CA19-9及CA242水平呈高表达状态,且上述因子联合MRCP技术可有效提高胆道恶性梗阻诊断准确率。

Objective To analyze clinical value of magnetic resonance cholangiopancreatography(MRCP)technology combined with carcinoembryonic antigen(CEA),cancer antigen19-9(CA19-9)and carbohydrate antigen242(CA242)in diagnosis of patients with malignant biliary obstructive diseases.Methods A total of 73 patients with biliary obstruction admitted between September 2015 and December 2020 were collected.Results of pathological diagnosis and MRCP characteristics were analyzed.Serum levels of CEA,CA19-9 and CA242 were compared between patients with benign and malignant biliary obstructive diseases,and the value of MRCP combined with the above factors in diagnosis of malignant biliary obstructive diseases was analyzed.Results Among 73 patients with biliary obstructive diseases,32 patients were malignant,and 41 patients were benign.Serum levels of CEA,CA19-9 and CA242 and positive expression rates of benign biliary obstructive lesions were significantly lower than those of malignant biliary obstructive lesions(P<0.01).MRCP showed features such as blockage of the bile duct at the obstructed end,double-tube sign and round blunt papillary shape.Bile ducts above the obstruction level were mostly severely dilated.The area under the receiver operating characteristic(ROC)curve of combined detection of CEA,CA19-9,CA242 and MRCP was the larger.Conclusion Serum levels of CEA,CA19-9 and CA242 in patients with malignant biliary obstructive diseases are highly expressed,and combined detection of the above factors and MRCP technology can effectively improve diagnostic accuracy for malignant biliary obstructive diseases.