血清D-二聚体、CA19-9联合CT对胰腺良恶性病变的诊断价值

Diagnostic Value of Serum D-dimer and CA19-9 Combined with CT for Benign and Malignant Lesions of the Pancreas

目的 探讨血清D-二聚体(D-D)、糖类抗原19-9(CA19-9)联合多层螺旋计算机断层扫描(MSCT)检查对胰腺良恶性病变的诊断价值。方法 选取我院2015年1月至2021年12月收治的经病理确诊的64例胰腺癌患者为观察组,41例胰腺良性病变患者为对照组,所有患者均行CT平扫及三期增强扫描,根据肿块的形状、边界、钙化、囊实性、强化程度,有无淋巴结肿大、血管累及、胰管扩张及胆管扩张来评估病灶的良恶性,检测血清D-D、CA19-9水平,以病理结果为金标准,评估血清D-D、CA19-9、MSCT单独及联合诊断胰腺良恶性病变的效能。结果 病理诊断64例胰腺癌患者中,CT正确诊断51例,误诊13例;41例胰腺良性病变患者中,CT正确诊断33例,误诊8例。观察组患者D-D水平及CA199水平均显著高于对照组D-D及CA199水平,差异有统计学意义(P<0.05)。CA19-9、D-D、MSCT单独及三项检查联合诊断对胰腺良恶性病变的敏感性分别为70.31%、76.56%、79.69%、89.06%;特异性分别为85.37%、75.61%、80.49%、95.12%;准确性分别为76.19%、76.19%、80.00%、91.43%。结论 MSCT联合血清D-D、CA19-9可提高胰腺良恶性病变诊断的效能,具有较高的临床价值。

Objective To investigate the diagnostic value of serum D-dimer(D-D)and glycoantigen 19-9(CA19-9)combined with multilayer spiral computed tomography(MSCT)examination for benign and malignant pancreatic lesions.Methods 64 patients with pathologically confirmed pancreatic cancer admitted to our hospital from January 2015 to December 2021 were selected as the observation group and 41 patients with benign pancreatic lesions were selected as the control group,and all patients underwent CT plain and three-phase enhancement scans to assess the benignity and malignancy of the lesions according to the shape,border,calcification,cystic solidity,degree of enhancement,presence of lymph node enlargement,vascular involvement,pancreatic duct dilatation and bile duct dilatation of the masses The efficacy of serum D-D,CA19-9 and MSCT alone and in combination for the diagnosis of benign and malignant pancreatic lesions was evaluated by measuring serum D-D and CA19-9 levels and using pathological examination as the gold standard.Results Among the 64 patients with pancreatic cancer diagnosed pathologically,CT correctly diagnosed 51 cases and misdiagnosed 13 cases;among the 41 patients with benign pancreatic lesions,CT correctly diagnosed 33 cases and misdiagnosed 8 cases.The D-D level and CA199 level of patients in the observation group were significantly higher than the D-D and CA199 levels in the control group,and the difference was statistically significant(P<0.05).The sensitivity of CA19-9,D-D,and MSCT alone and combined with the three tests for the diagnosis of benign and malignant pancreatic lesions was 70.31%,76.56%,79.69%,and 89.06%;the specificity was 85.37%,75.61%,80.49%,and 95.12%;and the accuracy was 76.19%,76.19%,80.00%,and 91.43%.Conclusion MSCT combined with serum D-D and CA19-9 can improve the efficacy of diagnosis of benign and malignant pancreatic lesions and have high clinical value.