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目的:用受试者工作特征曲线(ROC)分析血清CA19-9对胆管细胞癌的诊断、鉴别诊断价值,并对诊断界点(cut-off value)进行确定,以期对CA19-9应用于胆管细胞癌的诊断价值进行客观评价。方法:采用化学微粒子免疫发光法检测胆管细胞癌患者、肝细胞癌患者、肝血管瘤患者及健康对照血清CA19-9,绘制ROC曲线。结果:胆管细胞癌患者血清CA19-9较肝细胞癌患者、肝血管瘤患者及健康对照均高,有统计学意义(P<0.01)。胆管细胞癌与肝血管瘤比较的ROC曲线显示AUC为0.882,诊断界点值为55.09μ/mL时,敏感度达81.8%,特异度达99.0%;与肝细胞癌比较的AUC为0.830,诊断界点值为63.58μ/mL时,敏感度达81.8%,特异度达87.5%。结论:血清CA19-9检测对于胆管细胞癌的诊断及与肝细胞癌的鉴别诊断具有较高的价值。
Objective: To analyze the diagnostic value and differential diagnosis value of serum CA19-9 in patients with cholangiocarcinoma using the receiver operating characteristic curve (ROC), and to determine the cut-off value for the application of CA19-9 to the bile duct. The diagnostic value of cell carcinoma is evaluated objectively. Methods: We used chemical microparticle immunofluorescence to detect CA19-9 in patients with cholangiocarcinoma, hepatocellular carcinoma, hepatic hemangiomas, and healthy controls, and plotted ROC curves. Results: Serum CA19-9 levels in patients with cholangiocarcinoma were higher than those in patients with hepatocellular carcinoma, hemangiomas, and healthy controls, with statistical significance (P<0.01). The ROC curve of cholangiocarcinoma and hepatic hemangioma showed AUC of 0.882. The diagnostic cut-off point value was 55.09μ/mL, sensitivity was 81.8%, specificity was 99.0%, and AUC was 0.830 compared with hepatocellular carcinoma. When the cut-off value was 63.58μ/mL, the sensitivity was 81.8% and the specificity was 87.5%. Conclusion: The detection of serum CA19-9 has high value for the diagnosis of cholangiocarcinoma and differential diagnosis of hepatocellular carcinoma.