FBG、CEA、CA50在肝外胆管结石患者血清中的表达及相关性研究

Expression and correlation of FBG,CEA and CA50 in patients with extrahepatic cholangiolithiasis

目的探讨空腹血糖(FBG)、癌胚抗原(CEA)、糖类抗原50(CA50)在肝外胆管结石患者血清中的表达及相关性。方法收集2020年6月1日至2021年9月30日来廊坊市人民医院就诊的88例肝外胆管结石患者为病例组,另选取同时间段来廊坊市人民医院进行健康体检的65例健康者为对照组。收集并分析患者的临床资料,分析肝外胆管结石发生的相关因素;Pearson相关性分析肝外胆管结石患者血清FBG、CEA、CA50与总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的相关性;绘制受试者工作特征(ROC)曲线,分析各影响因素预测肝外胆管结石的曲线下面积和最佳截断值等;采用Logistic多元回归模型分析影响肝外胆管结石的独立危险因素。结果病例组与对照组在性别、吸烟、饮酒、心脏病、高血压及年龄方面的差异均无统计学意义(P>0.05);病例组血清FBG、CEA、CA50、TC、TG、LDL-C水平较对照组升高(P<0.05),血清HDL-C水平较对照组降低(P<0.05)。Pearson相关性分析发现,血清FBG、CEA、CA50水平与TC、TG、LDL-C水平均呈正相关(r>0,P<0.05);血清FBG、CEA、CA50水平均与HDL-C水平均呈负相关(r<0,P<0.05)。血清FBG、CEA、CA50、TC、TG、HDL-C、LDL-C单项检测及血清FBG、CEA、CA50联合检测诊断肝外胆管结石的曲线下面积分别为0.915、0.940、0.917、0.886、0.870、0.899、0.881、0.995,最佳截断值分别为5.4 mmol/L、4.9 ng/mL、23.1 U/mL、0.646、4.8 mmol/L、1.3 mmol/L、1.1 mmol/L、3.2 mmol/L。FBG、CEA、CA50、TC、TG是肝外胆管结石的独立危险因素(P<0.05),HDL-C是肝外胆管结石的保护因素(P<0.05)。结论肝外胆管结石患者血清FBG、CEA、CA50水平均升高,且其对肝外胆管结石具有较好的诊断价值。

Objective To investigate the expression and correlation of fasting blood glucose(FBG),carcinoembryonic antigen(CEA),and carbohydrate antigen 50(CA50)in patients with extrahepatic cholangiolithiasis.Methods A total of 88 patients with extrahepatic cholangiolithiasis who visited Langfang People's Hospital from June 1,2020 to September 30,2021 were collected as the case group,and 65 healthy individuals who visited Langfang People's Hospital for health examination during the same time period were selected as the control group.The clinical data of the patients were collected and analyzed to explore the factors associated with the occurrence of extrahepatic cholangiolithiasis.Pearson correlation analysis was performed between serum levels of FBG,CEA,and CA50 and levels of total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)in patients with extrahepatic cholangiolithiasis.Receiver operating characteristic(ROC)curve was drawn to analyze the area under the curve and optimal cut-off value,etc.,of each influencing factor to predict extrahepatic cholangiolithiasis.Logistic multiple regression model was used to analyze the independent risk factors affecting the occurrence of extrahepatic cholangiolithiasis.Results There were no statistically significant differences in sex,smoking,alcohol consumption,heart disease,hypertension,and age between between case group and control group(P>0.05).The serum levels of FBG,CEA,CA50,TC,TG and LDL-C in the case group were higher than those in the control group,while the serum HDL-C level was lower than that in the control group(P<0.05).Pearson correlation analysis showed that serum levels of FBG,CEA and CA50 were positively correlated with TC,TG and LDL-C(r>0,P<0.05).Serum levels of FBG,CEA and CA50 were negatively correlated with HDL-C(r<0,P<0.05).The area under the curve of FBG,CEA,CA50,TC,TG,HDL-C and LDL-C alone,and the combined detection of serum FBG,CEA,CA50 for diagnosing extrahepatic cholangiolithiasis were 0.915,0.940,0.917,0.886,0.870,0.899,0.881,0.995,respectively.The optimal cut-off values were 5.4 mmol/L,4.9 ng/mL,23.1 U/mL,0.646,4.8 mmol/L,1.3 mmol/L,1.1 mmol/L,3.2 mmol/L,respectively.FBG,CEA,CA50,TC and TG were independent risk factors for extrahepatic cholangiolithiasis(P<0.05),HDL-C was a protective factor for extrahepatic bile duct calculi(P<0.05).Conclusion Serum levels of FBG,CEA and CA50 were elevated in patients with extrahepatic cholangiolithiasis,and they have good diagnostic value for the extrahepatic cholangiolithiasis.