| 齐振平,李俊林,张秀玲,潘艳飞,付丹丹.血清肿瘤标志物联合多层螺旋CT和核磁共振对胆管癌的诊断价值及其与组织侵袭分子的关系分析[J].,2019,19(20):3951-3954 |
| 血清肿瘤标志物联合多层螺旋CT和核磁共振对胆管癌的诊断价值及其与组织侵袭分子的关系分析 |
| Diagnostic Value of Serum Tumor Markers Combined with Multi-slice Spiral CT and Nuclear Magnetic Resonance Imaging in Cholangiocarcinoma and Its Relation with Tissue Invasive Molecules |
| 投稿时间：2019-02-23 修订日期：2019-03-18 |
| DOI：10.13241/j.cnki.pmb.2019.20.034 |
| 中文关键词: 胆管癌 CA19-9 CA125 多层螺旋CT 核磁共振 |
| 英文关键词: Cholangiocarcinoma CA 19-9 CA 125 Multi-slice spiral CT Nuclear magnetic resonance |
| 基金项目:内蒙古自治区自然科学基金项目（2017MS(LH)0850） |
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| 中文摘要: |
| 摘要 目的：探讨血清癌抗原19-9（CA19-9）、糖类抗原125（CA125）、多层螺旋CT和核磁共振（MRI）联合检测对胆管癌的诊断价值，并分析肿瘤标志物与组织侵袭分子的相关性。方法：选择2017年1月至2018年8月赤峰学院附属医院收治的胆管癌患者62例作为胆管癌组，另选择同期我院收治的胆管良性病变患者55例作为胆管良性病变组。比较两组血清CA19-9、CA125水平以及组织侵袭分子含量，观察胆管癌患者和胆管良性病变患者的多层螺旋CT和MRI影像学征象，分析血清CA19-9、CA125、多层螺旋CT和MRI对胆管癌的诊断价值，并分析血清CA19-9、CA125水平与组织侵袭分子含量的相关性。结果：胆管癌组血清CA19-9、CA125水平高于胆总管良性病变组，胆管癌组织赖氨酰氧化酶样蛋白-2(LOXL2)、瞬时受体电位阳离子通道7（TRPM7）含量高于胆总管良性病变组，组织E钙黏素（E-cadherin）含量低于胆总管良性病变组（P<0.05）。多层螺旋CT影像学征象：胆管癌可见胆总管、肝管内圆形或类圆形高密度影伴有管壁浸润，胆管内出现不规则结节，肿块与周围组织界限模糊，胆囊管及胆囊颈部浸润，肝叶萎缩，淋巴结肿大等；胆管良性病变则多为圆形或类圆形高密度影，管壁浸润、淋巴结肿大并不多见。MRI影像学征象：胆管癌肝内胆管与肝组织分界不清，肿块呈不规则或分叶状，胆囊增大，肝内外胆管不同程度扩张，胰管扩张，肝叶萎缩，淋巴结肿大；胆管良性病变胆管则多为"杯口状"低信号充盈缺损，胆管梗阻上方出现"鸟嘴样"改变等。血清CA19-9、CA125、多层螺旋CT和MRI联合检测对胆管癌诊断的灵敏度、特异度、准确度均高于CA19-9、CA 125、多层螺旋CT、MRI单独诊断。胆管癌患者血清CA19-9、CA125水平与组织LOXL2、TRPM7含量呈正相关，与组织E-cadherin含量呈负相关（P<0.05）。结论：血清 CA19-9、CA125、多层螺旋CT和MRI联合检测对胆管癌诊断具有较好的价值，患者血清CA19-9、CA125水平与组织侵袭分子存在相关性，可以为胆管癌恶性程度的评估提供依据。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the diagnostic value of combined detection of serum cancer antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), multi-slice spiral CT and nuclear magnetic resonance (MRI) in cholangiocarcinoma, and to analyse the correlation between tumor markers and invasive molecules. Methods: 62 patients with cholangiocarcinoma who were admitted to affiliated Hospital of Chifeng University from January 2017 to August 2018 were selected as cholangiocarcinoma group. Another 55 patients with benign bile duct lesions admitted to our hospital during the same period were selected as the benign bile duct lesion group.The levels of serum CA19-9, CA125 and tissue invasive molecules content were compared between the two groups. The manifestations of multi-slice spiral CT and MRI in patients with cholangiocarcinoma and benign lesions of bile duct were observed. The diagnostic value of serum CA19-9, CA125, multi-slice spiral CT and MRI in cholangiocarcinoma were analyzed. The correlation between serum CA19-9, CA125 levels and tissue invasive molecules content were analyzed. Results: The serum levels of CA19-9 and CA125 in cholangiocarcinoma group were higher than those in benign lesions of common bile duct group. The contents of lysinoyl oxidase-like protein-2 (LOXL2) and transient receptor potential cation channel 7 (TRPM7) in cholangiocarcinoma group were higher than those in benign lesions of common bile duct group. The content of E-cadherin in tissues was lower than that in benign lesions of common bile duct group (P<0.05). Multi-slice spiral CT imaging signs: cholangiocarcinoma can be seen in the common bile duct, hepatic duct round or quasi-round high-density shadow with wall infiltration, irregular nodules in the bile duct, blurred boundaries between the mass and surrounding tissues, cystic duct and neck infiltration of the gallbladder, liver lobe atrophy, lymph node enlargement, etc. Benign bile duct lesions were mostly round or quasi-circular high-density shadow, wall infiltration and lymph node enlargement were rare. MR imaging signs: cholangiocarcinoma intrahepatic bile duct and liver tissue demarcation was not clear, the mass was irregular or lobulated, gallbladder enlargement, intrahepatic and extrahepatic bile duct dilatation in varying degrees, pancreatic duct dilatation, liver lobe atrophy, lymph node enlargement. Benign bile duct lesions were usually "cup-shaped" low-signal filling defect, and "bird's mouth" changed appear above bile duct obstruction. The sensitivity, specificity and accuracy of combined detection of serum CA19-9, CA125,multi-slice spiral CT and MRI in the diagnosis of cholangiocarcinoma were higher than those of CA19-9, CA125, multi-slice spiral CT and MRI alone. The serum levels of CA19-9 and CA125 in patients with cholangiocarcinoma were positively correlated with tissue LOXL2 and TRPM7 content, but negatively correlated with tissue E-cadherin content(P<0.05). Conclusion: The combined detection of serum CA19-9, CA125, multi-slice spiral CT and MRI has a good value in the diagnosis of cholangiocarcinoma. The levels of serum CA19-9 and CA125 in patients are correlated with tissue invasive molecules, which can provide a basis for the evaluation of malignant degree of cholangiocarcinoma. |
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