中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2014年
2期
76-79
,共4页
王丽梅%罗辉%王向平%陶芹%黄蕊%惠娜%刘志国%潘阳林%郭学刚
王麗梅%囉輝%王嚮平%陶芹%黃蕊%惠娜%劉誌國%潘暘林%郭學剛
왕려매%라휘%왕향평%도근%황예%혜나%류지국%반양림%곽학강
癌胚抗原%胆道疾病%诊断%红细胞体积分布宽度
癌胚抗原%膽道疾病%診斷%紅細胞體積分佈寬度
암배항원%담도질병%진단%홍세포체적분포관도
Carcinoembryonic antigen%Biliary tract diseases%Diagnosis%Red blood cell distribution width
目的 探讨红细胞体积分布宽度对胆道良恶性狭窄的诊断价值.方法 回顾性分析135例恶性胆道狭窄及53例良性胆道狭窄患者,将2组红细胞体积分布宽度(RDW)值进行对比,进一步分析RDW与胆道狭窄的部位、具体病因的关系,并与传统肿瘤标志物CA19-9、癌胚抗原(CEA)进行相关性检测分析.结果 胆道恶性狭窄组54.1％的患者RDW升高,明显高于良性狭窄组的18.9％,差异有统计学意义(P＜0.05).以RDW＞ 15.0％为界,发现其诊断恶性胆道狭窄的灵敏度和特异度分别为47％和81％.对于低位胆道梗阻(Bismuth Ⅰ+Ⅱ),良恶性组间RDW值比较,差异有统计学意义(P ＜0.001),恶性组明显升高;对于高位胆道梗阻(BismuthⅢ+Ⅳ),两者比较差异无统计学意义(P=0.505).同为良性狭窄或者恶性狭窄时,不同狭窄部位的RDW之间差异无统计学意义(P均＞0.05).相关性分析显示,RDW值与CA19-9(r=0.099,P=0.201)和CEA(r =0.115,P=0.152)均无明显相关性.CA19-9、CEA和RDW用于诊断恶性胆道狭窄的准确度分别为79％、69％和64％.结论 RDW值检测对胆道梗阻的定性诊断具有一定的价值,可作为独立于CA19-9、CEA的生化指标,用于鉴别胆道良恶性肿瘤.
目的 探討紅細胞體積分佈寬度對膽道良噁性狹窄的診斷價值.方法 迴顧性分析135例噁性膽道狹窄及53例良性膽道狹窄患者,將2組紅細胞體積分佈寬度(RDW)值進行對比,進一步分析RDW與膽道狹窄的部位、具體病因的關繫,併與傳統腫瘤標誌物CA19-9、癌胚抗原(CEA)進行相關性檢測分析.結果 膽道噁性狹窄組54.1％的患者RDW升高,明顯高于良性狹窄組的18.9％,差異有統計學意義(P＜0.05).以RDW＞ 15.0％為界,髮現其診斷噁性膽道狹窄的靈敏度和特異度分彆為47％和81％.對于低位膽道梗阻(Bismuth Ⅰ+Ⅱ),良噁性組間RDW值比較,差異有統計學意義(P ＜0.001),噁性組明顯升高;對于高位膽道梗阻(BismuthⅢ+Ⅳ),兩者比較差異無統計學意義(P=0.505).同為良性狹窄或者噁性狹窄時,不同狹窄部位的RDW之間差異無統計學意義(P均＞0.05).相關性分析顯示,RDW值與CA19-9(r=0.099,P=0.201)和CEA(r =0.115,P=0.152)均無明顯相關性.CA19-9、CEA和RDW用于診斷噁性膽道狹窄的準確度分彆為79％、69％和64％.結論 RDW值檢測對膽道梗阻的定性診斷具有一定的價值,可作為獨立于CA19-9、CEA的生化指標,用于鑒彆膽道良噁性腫瘤.
목적 탐토홍세포체적분포관도대담도량악성협착적진단개치.방법 회고성분석135례악성담도협착급53례량성담도협착환자,장2조홍세포체적분포관도(RDW)치진행대비,진일보분석RDW여담도협착적부위、구체병인적관계,병여전통종류표지물CA19-9、암배항원(CEA)진행상관성검측분석.결과 담도악성협착조54.1％적환자RDW승고,명현고우량성협착조적18.9％,차이유통계학의의(P＜0.05).이RDW＞ 15.0％위계,발현기진단악성담도협착적령민도화특이도분별위47％화81％.대우저위담도경조(Bismuth Ⅰ+Ⅱ),량악성조간RDW치비교,차이유통계학의의(P ＜0.001),악성조명현승고;대우고위담도경조(BismuthⅢ+Ⅳ),량자비교차이무통계학의의(P=0.505).동위량성협착혹자악성협착시,불동협착부위적RDW지간차이무통계학의의(P균＞0.05).상관성분석현시,RDW치여CA19-9(r=0.099,P=0.201)화CEA(r =0.115,P=0.152)균무명현상관성.CA19-9、CEA화RDW용우진단악성담도협착적준학도분별위79％、69％화64％.결론 RDW치검측대담도경조적정성진단구유일정적개치,가작위독립우CA19-9、CEA적생화지표,용우감별담도량악성종류.
Objective To investigate the diagnostic value of red blood cell distribution to differentiate benign biliary stricture (BBS) from malignant biliary stricture (MBS).Methods RDW and clinical features of biliary stricture lesions in 153 MBS patients were reviewed and compared with those 53 BBS patients.Correlation analyses among RDW,CA19-9 and CEA were also performed.Results RDW in MBS group was significantly higher than that of BBS group (P ＜ 0.05).The positive rates of RDW in MBS and BBS were 54.1％ and 18.9％ respectively,based on the prerequisite that RDW ＞ 15％ being the diagnostic value (P ＜ 0.05).The sensitivity and specificity of RDW in MBS diagnosis were 47％ and 81％ respectively.For patients with lower stricture (Ⅰ and Ⅱ),RDW of MBS was significantly higher than that of BBS (P ＜0.001) ; while for patients with higher stricture (Ⅲ and Ⅳ),the difference between MBS and BBS was not significant (P =0.505).For both MBS and BBS,there was no significant difference in RDW between strictures of Bismuth typeⅠ,Ⅱ and those of Ⅲ and Ⅳ (both P ＞ 0.05).In terms of correlation analysis,the RDW values were not positively correlated with CA19-9 (r =0.099,P =0.201) or CEA (r =0.115,P=0.152).The diagnostic accuracy of CEA,CA199 and RDW for MBS were 69％,79％ and 64％ respectively.Conclusion RDW is a valuable biochemical factor for discriminating MBS and BBS,which is independent of CA199 and CEA.
