内镜逆行胰胆管造影细胞刷检联合血清及胆汁CA199、CA125在胆管癌早期诊断中的应用价值

Application value of endoscopic retrograde cholangiopancreatography combined with serum and bile CA199 and CA125 in early diagnosis of cholangiocarcinoma

目的探讨内镜逆行胰胆管造影(ERCP)细胞刷检联合血清及胆汁CA199、CA125在胆管癌早期诊断中的应用价值.方法选择本院2017年5月~2019年4月收治的60例因胆管梗阻就诊的患者,均行血清及胆汁CA199、CA125检测、ERCP细胞刷检与胆管组织活检.以胆管组织活检的病理为基准计算血清、胆汁标志物、ERCP细胞刷检联合血清标志物诊断胆管癌的敏感度、特异度与准确率.结果60例患者中经组织病理检查证实胆管癌27例、良性胆管疾病33例.ERCP细胞刷检联合血清及胆汁标志物诊断胆管癌的敏感度、特异度、阳性预测值、阴性预测值略高于单纯血清标志物或单纯胆汁标志物检测,但差异无统计学意义(P>0.05).ERCP细胞刷检联合血清、胆汁标志物诊断诊断胆管癌的准确率为95.00%,显著高于血清标志物的81.67%及胆汁标志物78.33%(P<0.05).结论ERCP细胞刷检联合血清、胆汁标志物可提高胆管癌早期诊断的准确率,值得推广.

Objective To explore the value of endoscopic retrograde cholangiopancreatography(ERCP)cell brushing combined with serum and bile CAI99,CAI 25 in the early diagnosis of cholangiocarcinoma.Methods Sixty patients with biliary obstruction admitted to our hospital from January 2017to November 2019were examined by serum and bile CA199,CA125,ERCP cell brushing and bile duct biopsy.The sensitivity,specificity and accuracy of serum,bile markers,ERCP cell brushing combined with serum markers in the diagnosis of cholangiocarcinoma were calculated based on the pathology of bile duct biopsy.Results 60 patients with pathological examination confirmed 27 cases of cholangiocarcinoma and 33 cases of benign biliary tract disease.The sensitivity,specificity,positive predictive value and negative predictive value of ERCP cell brushing combined with serum and bile markers in the diagnosis of cholangiocarcinoma were slightly higher than those of serum markers or bile markers alone,but there was no significant difference(P>0.05).The diagnostic accuracy of ERCP cell brushing combined with serum and bile markers for cholangiocarcinoma was 95.00%,which was significantly higher than 81.67%of serum markers and 7&33%of bile markers(P<0.05).Conclusion ERCP cell brushing combined with serum and bile markers can improve the accuracy of early diagnosis of cholangiocarcinoma,which is worth pop­ularizing.