恶性胆汁淤积患者与胆结石所致胆汁淤积患者胆汁的生化特征比较。

Biochemical profile of bile fluid in patients with malignant cholestasis in comparison with cholestasis due to gall stone.

作者信息

Taheri Hassan, Ghemian Naser, Taghavi Yaser, Shokry-Shirani Javad

机构信息

Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran.

Department of Radiology, Babol University of Medical Sciences, Babol Iran.

出版信息

Caspian J Intern Med. 2015 Summer;6(3):165-9.

PMID:26644885

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4650793/

Abstract

BACKGROUND

Cholangiocarcinoma is an invasive biliary malignancy with poor prognosis. Diagnostic accuracy of conventional methods is low which is mainly due to the specific anatomy of the disease. The aim of this study was to evaluate the diagnostic value of biochemical profile and tumor marker of the bile in patients with malignant cholestasis compared to that of choledocholithiasis.

METHODS

In this cross-sectional study, 46 patients with extrahepatic cholestasis were enrolled (20 patients with malignant cholestasis and 26 patients with choledocolithiasis) A definitive diagnosis of cholangiocarcinoma was made by imaging, cytology and biopsy. Bile fluid was obtained by aspiration through endoscopic retrograde cholagiopantreatography (ERCP) catheter or percutaneous drainage in patients with choledocolithiasis and cholangiocarcinoma respectively. Sex and age were matched in two groups. Data regarding the biochemical profile (triglyceride, (TG), cholesterol, billirubin and HDL) and CA19.9 level of the bile fluid were collected, then using the SPSS software, the data were analyzed.

RESULTS

Bile fluid level of TG, cholesterol, high - density lipoprotein (HDL), direct bilirubin and CA19.9 were significantly higher in patients with benign cholestasis in comparison with malignant cholestasis (P<0.001, P<0.001, P<0.001, P=0.012 and P= 0.03, respectively).

CONCLUSION

Our study showed that the CA19.9 level of bile fluid in extrahepatic cholestasis due to biliary stone was significantly higher than those with cholangiocarcinoma, as is the biliary level of TG, cholesterol, high-density lipoprotein (HDL) and direct bilirubin. Thus they may help in the differentiation of benign versus malignant extra hepatic cholestasis.

摘要

背景

胆管癌是一种侵袭性胆管恶性肿瘤，预后较差。传统方法的诊断准确性较低，这主要归因于该疾病的特殊解剖结构。本研究的目的是评估与胆总管结石患者相比，恶性胆汁淤积患者胆汁的生化指标和肿瘤标志物的诊断价值。

方法

在这项横断面研究中，纳入了46例肝外胆汁淤积患者（20例恶性胆汁淤积患者和26例胆总管结石患者）。通过影像学、细胞学和活检对胆管癌做出明确诊断。分别通过经内镜逆行胰胆管造影（ERCP）导管抽吸或经皮引流获取胆总管结石和胆管癌患者的胆汁。两组在性别和年龄上相匹配。收集胆汁的生化指标（甘油三酯（TG）、胆固醇、胆红素和高密度脂蛋白）及CA19.9水平的数据，然后使用SPSS软件进行数据分析。