CA19-9检测在梗阻性黄疸诊断中的应用价值探讨

目的探讨血清CA19-9检测在梗阻性黄疸良恶性鉴别诊断中的价值。方法将选取良性梗阻性黄疸患者(良性梗阻组)19例和恶性梗阻性黄疸患者(恶性梗阻组)29例,治疗前后空腹检测静脉血CA19-9及总胆红素水平变化情况,并探讨两者之间的相关性。结果治疗后,良性梗阻组血清CA19-9与总胆红素水平均低于治疗前,且治疗后血清CA19-9与总胆红素水平低于恶性梗阻组,差异均有统计学意义(P<0.01);恶性梗阻组总胆红素水平低于治疗前,差异均有统计学意义(P<0.01)。治疗前后良性梗阻组血清CA19-9水平与血清总胆红素水平均呈正相关(r值分别为0.734和0.932,P<0.01),恶性梗阻组治疗前后两者均无相关性(r值分别为0.061和0.194,P>0.05)。结论动态监测梗阻性黄疸患者治疗前后血清CA19-9变化及血清CA19-9与总胆红素的相关性,有助于梗阻性黄疸患者的术前良恶性诊断及鉴别。

Investigation of application value of CA19-9 detection in the diagnosis of obstructive jaundice

Objective To explore the value of serum CA19-9 detected in benign and malignant differential diagnosis of obstructive jaundice. Methods Selected 19 cases patients with benign obstructive jaundice（ benign obstruction group） and 29 cases patients with malignant obstructive jaundice（ malignant obstruction group） ,before and after treatment to detect blood CA19-9 and total bilirubin level changes,and to explore both the correlation. Results After the treatment,the serum CA19-9 and total bilirubin reduced, and after treatment the levels of serum CA19-9 and total bilirubin were lower than those of malig- nant obstruction group, the difference were statistically significant（ P 〈 O. 01 ） ;The total bilirubin level of malignant obstruction group was lower than that before treatment（P 〈0. O1 ）. Before and after treatment,the level of of serum CA19-9 level and ser- um total bilirubin of benign obstructive group was positively correlated （r = O. 734 and 0. 932, P 〈 0. 01 ）, but malignant ob- struction group related resistance（ r = 0.061 and 0. 194,P 〈 0.05）. Conclusion Dynamic monitoring of patient with obstruc- tive jaundice before and after treatment serum of CA19-9 change and the correlation between serum CA19-9 and total bilirubin, contribute to the malignant and benign obstructive jaundice in patient with preoperative diagnosis and differential.