郑州大学学报(医学版)
鄭州大學學報(醫學版)
정주대학학보(의학판)
JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES)
2013年
5期
661-663
,共3页
杨万荷%李家群%仝亚林%李林静%李治国%冯百岁
楊萬荷%李傢群%仝亞林%李林靜%李治國%馮百歲
양만하%리가군%동아림%리림정%리치국%풍백세
糖类抗原19-9%纤维蛋白原%梗阻性黄疸%鉴别诊断
糖類抗原19-9%纖維蛋白原%梗阻性黃疸%鑒彆診斷
당류항원19-9%섬유단백원%경조성황달%감별진단
carbohydrate antigen 19-9%fibrinogen%obstructive jaundice%differential diagnosis
目的:评价血清糖类抗原19-9(CA19-9)和血浆纤维蛋白原(FIB)水平在良、恶性梗阻性黄疸鉴别诊断中的价值。方法:收集60例良性和75例恶性梗阻性黄疸患者,采用全自动免疫分析仪经电化学发光法检测血清CA19-9,采用全自动血栓/止血分析仪经光学法检测血浆FIB,绘制ROC曲线,确定诊断界值,计算特异度及灵敏度。结果:恶性梗阻性黄疸患者血清CA19-9及血浆FIB水平均高于良性梗阻性黄疸患者(Z=7.420,6.862,P<0.05)。 ROC曲线分析结果显示:AUC(CA19-9)为0.872,95%可信区间(0.813~0.931);AUC(FIB)为0.844,95%可信区间(0.777~0.912)。取灵敏度+特异性的最高值所对应的截断点作为诊断界点,CA19-9的界点为35.085 U/mL,FIB为2.45 g/L,2者在选定界点的灵敏度(95%可信区间)分别为88.0%(82.5%~93.5%)和84.0%(77.8%~90.2%),联合检测灵敏度增加至98.7%(98.2%~99.2%)。结论:血清CA19-9与血浆FIB联合检测可提高良、恶性梗阻性黄疸鉴别诊断的灵敏度。
目的:評價血清糖類抗原19-9(CA19-9)和血漿纖維蛋白原(FIB)水平在良、噁性梗阻性黃疸鑒彆診斷中的價值。方法:收集60例良性和75例噁性梗阻性黃疸患者,採用全自動免疫分析儀經電化學髮光法檢測血清CA19-9,採用全自動血栓/止血分析儀經光學法檢測血漿FIB,繪製ROC麯線,確定診斷界值,計算特異度及靈敏度。結果:噁性梗阻性黃疸患者血清CA19-9及血漿FIB水平均高于良性梗阻性黃疸患者(Z=7.420,6.862,P<0.05)。 ROC麯線分析結果顯示:AUC(CA19-9)為0.872,95%可信區間(0.813~0.931);AUC(FIB)為0.844,95%可信區間(0.777~0.912)。取靈敏度+特異性的最高值所對應的截斷點作為診斷界點,CA19-9的界點為35.085 U/mL,FIB為2.45 g/L,2者在選定界點的靈敏度(95%可信區間)分彆為88.0%(82.5%~93.5%)和84.0%(77.8%~90.2%),聯閤檢測靈敏度增加至98.7%(98.2%~99.2%)。結論:血清CA19-9與血漿FIB聯閤檢測可提高良、噁性梗阻性黃疸鑒彆診斷的靈敏度。
목적:평개혈청당류항원19-9(CA19-9)화혈장섬유단백원(FIB)수평재량、악성경조성황달감별진단중적개치。방법:수집60례량성화75례악성경조성황달환자,채용전자동면역분석의경전화학발광법검측혈청CA19-9,채용전자동혈전/지혈분석의경광학법검측혈장FIB,회제ROC곡선,학정진단계치,계산특이도급령민도。결과:악성경조성황달환자혈청CA19-9급혈장FIB수평균고우량성경조성황달환자(Z=7.420,6.862,P<0.05)。 ROC곡선분석결과현시:AUC(CA19-9)위0.872,95%가신구간(0.813~0.931);AUC(FIB)위0.844,95%가신구간(0.777~0.912)。취령민도+특이성적최고치소대응적절단점작위진단계점,CA19-9적계점위35.085 U/mL,FIB위2.45 g/L,2자재선정계점적령민도(95%가신구간)분별위88.0%(82.5%~93.5%)화84.0%(77.8%~90.2%),연합검측령민도증가지98.7%(98.2%~99.2%)。결론:혈청CA19-9여혈장FIB연합검측가제고량、악성경조성황달감별진단적령민도。
Aim:To explore the value of serum carbohydrate antigen 19-9(CA19-9) combined with plasma fibrinogen ( FIB) for the differential diagnosis of benign and malignant obstructive jaundice .Methods:A total of 60 benign obstruc-tive jaundice patients and 75 malignant obstructive jaundice patients were subjected to detect the serum CA 19-9 and plasma FIB.The serum CA19-9 was detected via the electrochemical luminescence method .The plasma FIB was detected via the optics method.The diagnostic performance of CA 19-9 and FIB in the benign and malignant obstructive jaundice was evalua-ted with ROC curve .Results:The levels of CA19-9 and FIB of the malignant obstructive jaundice patients were signifi-cantly higher than those of benign patients (Z=7.420,6.862,P<0.05).The AUC(CA19-9) and AUC(FIB) of ROC curve were 0.872 and 0.844,and 95%CI was (0.813-0.931) and (0.777-0.912).When the cut-off point was deter-mined as 35.085 U/mL for CA19-9 and 2.45 g/L for FIB on the basis of highest value of sensitivity and specificity , thesensitivity(95%CI) of CA19-9, FIB, and combined detection were 88.0%(82.5% -93.5%),84.0%(77.8% -90.2%), and 98.7%(98.2% -99.2%).Conclusion: The combined detection of CA19-9 and FIB can improve thesensitivity of differential diagnosis of benign and malignant obstructive jaundice .