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目的 :探讨影像学检查和糖链抗原 (CA19 9)、癌胚抗原 (CEA)测定对肝外胆管癌 (extrahepaticcholangiocarcinoma,E HCC)的诊断价值 .方法 :回顾性分析 10 7例肝外胆管癌超声(US)、CT、磁共振胆胰管造影 (MRCP)、内窥镜逆行胰胆管造影(ERCP)和经皮经肝胆道造影术 (PTC)诊断结果 ,并与手术及病理结果对照 .其中 ,5 1例进行了血清CA19 9,CEA测定 ,2 2例进行了胆汁CA19 9,CEA的测定 ,并分别与胆道良性病变进行对照 .通过ROC曲线界定CA19 9,CEA对EHCC的诊断价值 .结果 :肿块显示率US,CT ,ERCP分别为 70 .8% ,6 0 .2 %和6 9.0 % ;定位诊断准确率US ,CT ,MRCP ,ERCP和PTC分别为72 .9% ,75 .9% ,10 0 % ,71.4 %和 76 .9% ;定性诊断准确率US ,CT ,MRCP ,ERCP ,PTC分别为 70 .8% ,73.5 % ,86 .2 % ,6 1.9%和5 8.3% .EHCC组与胆道良性病变组相比较 ,血清CA19 9,CEA浓度明显升高 (P <0 .0 1,P <0 .0 5 ) .接收者工作特征 (ROC)曲线显示 ,血清CA19 9,CEA和胆汁CA19 9的ROC曲线下面积 (theareaundertheROCcurve ,AUC)分别为 0 .94 2 (P <0 .0 0 1) ,0 .5 16 (P >0 .0 5 )和 0 .74 6 (P <0 .0 1) ;结果显示血清CA19 9和胆汁CA19 9对EHCC有较好的诊断价值 .血清CA19 9,CEA和胆汁CA19 9,CEA的敏感性分别为 86 % ,2 6 % ,5
Objective: To investigate the diagnostic value of imaging examination and carbohydrate chain antigen (CA19 9) and carcinoembryonic antigen (CEA) in the diagnosis of extrahepatic cholangiocarcinoma (E HCC) .Methods: A retrospective analysis of 107 cases of extrahepatic cholangiocarcinoma (CT), magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC), and compared with the results of surgery and pathology.Among them, 51 cases of serum CA19 9, CEA determination, 22 cases of bile CA19 9, CEA were measured and benign biliary lesions were compared by ROC curve defined CA19 9, CEA diagnostic value of EHCC.Results: The diagnostic accuracy rates of US, CT, MRCP, ERCP and PTC were 72.9% and 75.9% respectively for US, CT and ERCP, with the rates of US, CT and ERCP being 70.8%, 60.2% and 69.0% The diagnostic accuracy rates of US, CT, MRCP, ERCP and PTC were 70.8%, 73.5%, 86.2%, 6 1.9% and 53.3% respectively in the EHCC group The serum CA19 9 and CEA concentrations were significantly higher in patients with benign biliary disease (P <0.01, P <0.05) .ROC curves showed that serum CA19 9, CEA and bile CA19 9 The area under the ROC curve (AUC) was 0.94 2 (P <0.001), 0.56 (P> 0.05) and 0.746 (P <0.01) The results showed that serum CA19 9 and bile CA19 9 had good diagnostic value for EHCC.The sensitivity of serum CA19 9, CEA and bile CA19 9, CEA were 86%, 26%, 5