摘要
目的 探讨胆管癌(CCA)和胰腺癌(PCC)胆管中胆汁酸组成差异及其临床意义.方法 选取2019年10月至2021年10月重庆医科大学附属第二医院收治的34例良性胆道疾病(BBD)患者、20例CCA患者和8例PCC患者,通过经内镜逆行胰胆管造影(ERCP)术采集患者的胆汁,利用液相色谱串联质谱(LC-MS/MS)法分析62例患者胆汁中的40种胆汁酸.结果 CCA患者胆汁中甘氨石胆酸(GLCA)、总非结合胆汁酸、总结合胆汁酸、甘氨结合胆汁酸、甘氨鹅脱氧胆酸(GCDCA)、甘氨脱氧胆酸(GDCA)、牛磺脱氧胆酸(TDCA)、23-脱甲胆酸(23-NorCA)、次级胆汁酸、鹅去氧胆酸(CDCA)、总胆汁酸水平显著低于BBD患者,而PCC患者胆汁中牛磺胆酸(TCA)、初级胆汁酸水平显著高于BBD组,差异均有统计学意义(P＜0.05).结论 23-NorCA、TDCA、CD-CA、次级胆汁酸、总胆汁酸可作为辅助诊断CCA的潜在生物学标志物,初级胆汁酸、TCA对PCC的辅助诊断有一定参考价值.
Abstract
Objective To investigate the difference of bile acid composition in bile ducts of cholangio-carcinoma(CCA)and pancreatic cancer(PCC)and its clinical significance.Methods A total of 34 patients with benign biliary disease(BBD),20 patients with CCA and eight patients with PCC admitted to the the Sec-ond Affiliated Hospital of Chongqing Medical University from October 2019 to October 2021 were selected to collect bile by endoscopic retrograde cholangiography(ERCP).The 40 bile acids in 62 patients were analyzed by liquid chromatography tandem mass spectrometry(LC-MS/MS).Results The levels of glycinocholic acid(GLCA),total unconjugated bile acid,total conjugated bile acid,glycine conjugated bile acid,glycinodeoxy-cholic acid(GCDCA),glycine deoxycholic acid(GDCA),taurine deoxycholic acid(TDCA),23-methylcholic acid(23-NorCA),secondary bile acid,chenodeoxycholic acid(CDCA),and total bile acid in the bile of CCA patients were significantly lower than those in the BBD group,while the levels of taurocholic acid(TCA)and primary bile acid in the bile of the PCC group were significantly higher than those in the BBD group,with statistical significance(P＜0.05).Conclusion 23-NorCA,TDCA,CDCA,secondary bile acids and total bile acids can be used as potential biomarkers to assist the diagnosis of CCA,and primary bile acids and TCA have certain ref-erence value for the auxiliary diagnosis of PCC.
维普
万方数据