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目的检测患者血清、胆汁基质金属蛋白酶7(MMP-7)表达水平,探讨其对胆管癌的临床诊断价值。方法收集2011年12月至2012年6月东方肝胆外科医院内镜科29例胆管癌患者和20例良性狭窄患者的血清和胆汁样本。用ELISA方法检测血清、胆汁MMP-7表达水平,分析它们诊断胆管癌的敏感性、特异性及与临床参数的关系。结果血清MMP-7表达胆管癌组[(5.42±0.30)ng/ml]高于良性组[(4.28±0.19)ng/ml],差别有统计学意义(P=0.009)。以4.88ng/ml(AUC0.722,95%CI0.580～0.865)为界值,血清MMP-7诊断胆管癌的敏感性为65.5%、特异性为80.0%。胆汁MMP-7表达胆管癌组[(10.05±0.69)ng/ml]高于良性组[(8.26±0.443)ng/ml],差别有统计学意义(P=0.012);以8.32ng/ml(AUC0.713,95%CI0.564～0.862)为界值,胆汁MMP-7诊断胆管癌的敏感性为75.9%、特异性为65.0%。血清、胆汁MMP-7表达水平与临床参数无明显相关性。结论血清、胆汁MMP-7可以作为诊断胆管癌的标记物,且对鉴别胆管癌和胆道良性病变有一定的意义。
Objective To detect the serum and bile matrix metalloproteinase 7 (MMP-7) expression levels and explore its clinical value of diagnosis of cholangiocarcinoma. Methods Serum and bile samples from 29 patients with cholangiocarcinoma and 20 patients with benign stenosis from December 2011 to June 2012 in the Eastern Hepatobiliary Surgery Hospital were collected. Serum and bile MMP-7 expression levels were detected by ELISA, and their sensitivity, specificity and clinical parameters were analyzed. Results The serum level of MMP-7 in cholangiocarcinoma group [(5.42 ± 0.30) ng / ml] was significantly higher than that in the benign group [(4.28 ± 0.19) ng / ml], the difference was statistically significant (P = 0.009). With 4.88ng / ml (AUC0.722, 95% CI0.580-0.865) as the cutoff, the sensitivity and specificity of serum MMP-7 in diagnosing cholangiocarcinoma were 65.5% and 80.0% respectively. The expression of bile MMP-7 in cholangiocarcinoma group [(10.05 ± 0.69) ng / ml] was significantly higher than that in the benign group [(8.26 ± 0.443) ng / ml] AUC0.713, 95% CI0.564 ~ 0.862). The sensitivity and specificity of bile MMP-7 in diagnosing cholangiocarcinoma were 75.9% and 65.0% respectively. Serum, bile MMP-7 expression levels and clinical parameters no significant correlation. Conclusion Serum and bile MMP-7 can be used as markers for the diagnosis of cholangiocarcinoma, and have certain significance for the differential diagnosis of cholangiocarcinoma and biliary benign lesions.