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目的:探讨血清颗粒蛋白前体(progranulin,PGRN)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、甲胎蛋白(AFP)检测在鉴别胆管良恶性病变中的价值。方法:检测31例术后病理证实的胆管癌患者、30例胆管良性病变患者及10名健康人的血清PGRN、CA19-9、CEA、AFP。结果:血清PGRN、CA19-9、CEA水平在胆管癌患者、胆管良性病变患者及正常人中依次降低(P<0.01)。胆管癌患者及胆管良性病变患者的血清AFP较正常人均明显升高(P<0.01),但胆管癌与胆管良性病变患者间的差异则无统计学意义(P>0.05)。PGRN鉴别胆管良恶性病变的灵敏度最高(83.87%),而CA19-9的特异度最高(100%)。联合检测采用并联试验可进一步提高诊断的灵敏度和诊断效能。结论:PGRN有作为胆管肿瘤标志物的潜力,与CA19-9、CEA、AFP联合检测可有较高的诊断价值。
Objective: To investigate the value of detecting progranulin (PGRN), carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA) and alpha fetoprotein (AFP) in differentiating benign and malignant lesions of bile duct. Methods: Serum PGRN, CA19-9, CEA and AFP were detected in 31 patients with pathologically confirmed cholangiocarcinoma, 30 patients with benign biliary lesions and 10 healthy controls. Results: The serum levels of PGRN, CA19-9 and CEA decreased in cholangiocarcinoma patients, benign cholangiocarcinoma patients and normal controls (P <0.01). Serum AFP in patients with cholangiocarcinoma and benign biliary diseases was significantly higher than that in normal people (P <0.01), but there was no significant difference between patients with cholangiocarcinoma and benign biliary diseases (P> 0.05). PGRN had the highest sensitivity (83.87%) for differentiating benign and malignant biliary lesions, while CA19-9 had the highest specificity (100%). Joint testing using parallel tests can further improve the diagnostic sensitivity and diagnostic efficacy. Conclusion: PGRN has the potential of being a marker of cholangiocarcinoma. Combined with CA19-9, CEA and AFP, it may have higher diagnostic value.