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目的探讨血清糖类抗原CA19-9检测在慢性乙型肝炎病毒(HBV)感染患者中的临床价值。方法选取2012年1月-2015年1月在本院住院的慢性HBV感染患者291例,检测所有患者血清CA19-9和其他实验室指标。比较不同病情慢性HBV感染患者血清CA19-9水平和阳性率的差异,分析其他指标与血清CA19-9的相关性,并采用ROC曲线评价血清CA19-9对肝癌的诊断价值。结果随着疾病进展,血清CA19-9水平及阳性率均逐步升高,差异有统计学意义(χ2值分别为34.72、22.95,P<0.01)。血清CA19-9与多项肝功能指标有相关性,特别是与球蛋白(GLB)和总胆汁酸(TBA)的相关性较显著(r>0.30)。血清CA19-9诊断肝癌的ROC曲线下面积(AUC)为0.63(0.57~0.69)。结论慢性HBV感染患者体内血清CA19-9水平显著升高,而且与病情轻重有密切关系,对血清CA19-9的动态观察有助于监测病情变化,但用于诊断肝癌的价值有限。
Objective To investigate the clinical value of serum carbohydrate antigen CA19-9 in patients with chronic hepatitis B virus (HBV) infection. Methods A total of 291 patients with chronic HBV infection admitted to our hospital from January 2012 to January 2015 were enrolled in this study. Serum CA19-9 and other laboratory parameters were measured in all patients. The difference of serum CA19-9 level and positive rate in patients with chronic HBV infection of different conditions was analyzed. The correlation between other indexes and serum CA19-9 was analyzed. The diagnostic value of serum CA19-9 in liver cancer was evaluated by ROC curve. Results As the disease progressed, the level of serum CA19-9 and the positive rate increased gradually, the difference was statistically significant (χ2 values were 34.72,22.95, P <0.01). Serum CA19-9 was associated with a number of liver function parameters, especially with globulin (GLB) and total bile acid (TBA) (r> 0.30). The area under the ROC curve (AUC) of serum CA19-9 in diagnosis of HCC was 0.63 (0.57-0.69). Conclusions The level of serum CA19-9 in patients with chronic HBV infection is significantly elevated and closely related to the severity of the disease. The dynamic observation of serum CA19-9 is helpful to monitor the changes of the disease, but the value of the serum CA19-9 for the diagnosis of liver cancer is limited.