血清 CA19-9 水平在良性胆管疾病患者中的临床意义

背景: CA19-9是临床常用的肿瘤标记物,对胰胆系恶性肿瘤的阳性率较高,但良性胆管疾病中亦常见CA19-9水平升高。目的: 分析血清CA19-9水平在良性胆管疾病患者中的临床意义。方法: 选取2004年10月～2009年5月北京军区总医院的78例经ERCP证实的良性胆管疾病患者(60例胆总管结石和18例胆总管炎性狭窄)。所有患者于ERCP术前行血清CA19-9水平检测,并分析其在良性胆管疾病中的临床意义。结果: 39例(50.0%)患者血清CA19-9水平正常,其中胆总管结石26例(66.7%)。其余39例(50.0%)患者血清CA19-9水平升高,其中胆总管结石34例(87.2%);4例血清CA19-9水平1000U/ml者的年龄均65岁,并合并有严重化脓性梗阻性胆管炎或重症急性胰腺炎。16例血清CA19-9升高者于ERCP术后行复查,多数患者血清CA19-9水平明显下降。结论: 良性胆管疾病患者中血清CA19-9水平可升高,可作为预测胆管炎症程度的指标,尤其是在老年患者中。

Clinical Significance of Serum CA19-9 Level in Patients with Benign Bile Duct Diseases

CA19-9 is a tumor marker frequently used in clinical practice and has a high positivity rate in malignant tumors of pancreaticobiliary system, However, raised serum CA 19-9 level also can be seen in benign bile duct diseases. Aims： To analyze the clinical significance of serum CA19-9 level in patients with benign bile duct diseases. Methods： Seventy-eight patients with benign bile duct diseases diagnosed by ERCP were collected from October 2004 to May 2009 in the Military General Hospital of Beijing, including 60 cases of common bile duct calculi and 18 chalangitic stenosis. Serum CA19-9 level was determined before performing ERCP, and its clinical significance in benign bile duct diseases was analyzed. Results： Normal serum CA19-9 level was seen in 39 patients （50.0%）, 26 of them （66.7%） were patients with common bile duct calculi. Serum CA19-9 level was increased in the other 39 patients （50.0%）, including 34 （87.2%） common bile duct calculi; serum CA19-9 level exceeded 1000 U/ml in 4 patients with the age〉65 years and accompanied with severe suppurative obstructive cholangitis or severe acute pancreatitis. Serum CA19-9 level was measured in 16 patients after performing ERCP and showed an obvious decrease in most cases. Conclusions： Increased serum CA19-9 level can also be seen in patients with benign bile duct diseases, and can serve as an inflammatory marker for predicting the severity of eholangitis, especially in elderly patients.