老年胆囊结石患者血清CA19-9、CA50表达及其与胆道炎症的相关性研究

Expressions of serum CA19-9 and CA50 and their correlation with biliary tract inflammation in elderly patients with gallstones

目的:探讨老年胆囊结石患者血清糖类抗原19-9(CA19-9)、糖类抗原50(CA50)表达水平及其与胆道炎症的相关性。方法:回顾性分析120例老年胆囊结石患者病历资料,根据胆道炎症程度将其分为轻度亚组(n=40)、中度亚组(n=56)和重度亚组(n=24),以同期50名健康体检者为对照组。比较观察组与对照组血清CA19-9、CA50表达水平及观察组各亚组血清CA19-9、CA50、炎症因子表达水平,分析血清CA19-9、CA50表达与胆道炎症程度的相关性。结果:观察组血清CA19-9、CA50表达水平均高于对照组(P<0.05);受试者工作特征(ROC)曲线分析显示,血清CA19-9、CA50单独及联合检测均对胆囊结石有一定诊断价值,但联合检测诊断效能更高,其ROC曲线下面积(AUC)值为0.801,高于血清CA19-9、CA50单独检测(P<0.05);重度亚组血清CA19-9、CA50、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)和C反应蛋白(CRP)表达水平均高于轻度亚组和中度亚组,且中度亚组血清CA19-9、CA50、IL-6、TNF-α、CRP表达水平高于轻度亚组(P<0.05);Spearman相关性分析显示,血清CA19-9、CA50表达水平与胆道炎症程度呈正相关(P<0.05)。结论:老年胆囊结石患者血清CA19-9、CA50与胆道炎症有一定关联性,其表达水平随胆道炎症严重程度增加而升高,可指导胆道炎症的判断。

Objective:To explore the expressions of serum carbohydrate antigen 19-9(CA19-9)and carbohydrate antigen 50(CA50)and their correlation with biliary tract inflammation in elderly patients with gallstones.Methods:A total of 120 elderly patients with gallstones were selected as the observation group.According to the degree of biliary tract inflammation,they were divided into mild subgroup(n=40),moderate subgroup(n=56)and severe subgroup(n=24).Meanwhile,50 healthy individuals were selected as control group.Serum CA19-9 and CA50 were compared between the observation group and the control group.Serum CA19-9,CA50,and inflammatory factors were compared among subgroups of the observation group.The correlation between the expression of serum CA19-9,CA50 and the degree of biliary tract inflammation was analyzed.Results:Serum CA19-9 and CA50 levels in the observation group were higher than those in the control group(P<0.05).ROC curve analysis showed that both serum CA19-9,CA50 alone and in combination could be applied to diagnose gallstone,but combined detection could achieve a higher diagnostic efficiency.The area under the ROC curve(AUC)value of combined detection was 0.801,which was significantly higher than that of serum CA19-9 or CA50 alone(P<0.05).Serum CA19-9,CA50,interleukin-6(IL-6),tumor necrosis factorα(TNF-α)and C-reactive protein(CRP)levels decreased in sequence from the severe subgroup,the moderate subgroup to the mild subgroup(P<0.05).Spearman correlation analysis showed that serum CA19-9 and CA50 levels were positively correlated with the degree of biliary tract inflammation(P<0.05).Conclusion:The expression of serum CA19-9 and CA50 in elderly patients with gallstones is related to biliary tract inflammation.In addition,levels of the two increase as biliary tract inflammation aggravates,which indicates that they can be used as reference indexes for clinical diagnosis of biliary tract inflammation.