首页|血清GGT,GGT/ALP及CA19-9检测在恶性梗阻性黄疸诊断中的价值

血清GGT,GGT/ALP及CA19-9检测在恶性梗阻性黄疸诊断中的价值

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目的:探讨血清γ-谷氨酰转移酶(GGT)、γ-谷氨酰转移酶/碱性磷酸酶(GGT/ALP)及糖类相关抗原199(CA19-9)对恶性梗阻性黄疸的临床诊断价值.方法:回顾性分析我院2002-07/2007-07收治的366例梗阻性黄疸患者的临床资料,根据临床诊断分成恶性梗阻性黄疸组、结石伴炎件梗阻性黄疸组及结石不伴炎性梗阻性黄疸组3组;同时选择健康志愿者40例作为正常对照组.术前采用放射免疫法检测血清中CA19-9水平,采用全自动生化仪检测血清GGT和ALP水平.结果:梗阻性黄疸各组各指标均显著高于正常对照组(P<0.05);在梗阻性黄疸病例中,恶性梗阻性黄疸组GGT,CA19-9水平显著高于结石性梗阻性黄疸组(P<0.05),恶性梗阻性黄疽组GGT/ALP比值显著低于结石性梗阻性黄疸组(P<O.05);结石伴炎性梗阻性黄疸组GGT、水平显著高于结石不伴炎性梗阻性黄疸组(P<0.05),两组间CA19-9水平及GCT/ALP比值无统计学差异(P>0.05);GGT和CA19-9单独检测对恶性梗阻性黄疸的诊断率分别为81.56%,和72.63%,GGT联合CA19-9检测对恶性梗阻性黄疸的诊断率为92.74%,GGT联合CA19-9检测对恶性梗阻性黄疸的诊断率显著高于GGT及CA19-9单独检测(P<0.05).结论:血清GGT,GGT/ALP及CA19-9检测可辅助良、恶性梗阻性黄疽的鉴别诊断,GGT联合CA19-9检测能够提高恶性梗阻性黄疸的诊断率.
Clinical diagnosis value of combined detection of GGT, GGT/ALP ratio and CA19-9 in patients with malignant obstructive jaundice
AIM:To evaluate the diagnostic value of combined detection of serum GGT, GGT/ALP ratio and CA19-9 in patients with malignant obstructive jaundice. METHODS:A total of 366 patients diagnosed as obstructive jaundice in our hospital from July 2002 to July 2007 were included in this retrospective study. All the study objects were divided into 3 groups according to the clinical diagnosis:Neoplastic obstructive jaundice group, biliary calculi with inflammation obstructive jaundice group and biliary calculi without inflammation obstructive jaundice group. Forty healthy volunteers were recognized as control group. Serum CA19-9 levels was determined by radioimmunoassay, srum GGT and ALP levels were determined by absorption spectrometry.RESULTS:There are significant differences in the levels of GGT, GGT/ALP and CA19-9 between control group and the obstructive jaundice groups(P < 0.05); In the obstructive jaundice groups the levels of GGT and CA19-9 were significantly higher in neoplastic obstructive jaundice group than the biliary calculi obstructive jaundice groups(P < 0.05), but the levels of GGT/ ALP were significantly lower in neoplastic obstructive jaundice group(P < 0.05); the levels of GGT were significantly higher in biliary calculi with inflammation obstructive jaundice group than biliary calculi without inflammation obstructive jaundice group (P < 0.05), but no significant differences in the levels of GGT/ALP and CA19-9 were found between the two groups(P >0.05).The diagnosis rates of neoplastic obstructive jaundice using GGT,CA19-9 and the combined detection were 81.56%, 72.63% and 92.74%, respectively. The diagnosis rates of combined detection were significantly higher than using GGT or CA19-9 separately (P<0. 05). CONCLUSION:The detection of GGT, GGT/ALP and CA19-9 can assist the identification of benign and malignant obstructive jaundice. The combined detection can improve the diagnosis rate of neoplastic obstructive jaundice.

GGTALPCA19-9obstructive jaundice

刘栋、吴齐飞、刘昌、张晓刚、王博、刘学民、于良、吕毅

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西安交通大学医学院第一附属医院肝胆外科,陕西,西安,710061

GGT AIP CA19-9 梗阻性黄疸

2009

第四军医大学学报
第四军医大学

第四军医大学学报

CSTPCDCSCD北大核心
影响因子:0.599
ISSN:1000-2790
年,卷(期):2009.30(24)
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