Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Innovation Institute of China Medical University, Shenyang, Liaoning, China.
Carcinogenesis. 2021 Apr 17;42(3):442-447. doi: 10.1093/carcin/bgaa125.
Hilar cholangiocarcinoma (HCCA), which lacks specific clinical manifestations, remains very difficult to distinguish from benign disease. This distinction is further complicated by the complex hilar anatomy. We conducted the present study to evaluate the differential diagnosis of these conditions. Sixty-five patients underwent resection surgery for suspected HCCA between January 2011 and October 2018. Institutional Review Board of Shengjing hospital agreed this study and all participants sign an informed consent document prior to participation in a research study. Following a postoperative pathology analysis, all patients were divided into two groups: malignant group (54 patients with HCCA) and benign group (11 cases with benign lesions). Compared with the benign group, the malignant group had a significantly higher median age and serum CA19-9, CEA, ALT, BILT and BILD levels (P < 0.05). In contrast, the groups did not differ significantly in terms of the sex distribution, clinical manifestations, serum levels of AST and ALKP, and imaging findings. In a receiver operating characteristic curve analysis, we identified a CA19-9 cutoff point of 233.15 U/ml for the differential diagnosis and CEA cutoff point of 2.98 ng/ml for the differential diagnosis. The differential diagnosis of HCCA and benign hilar lesions remains difficult. However, we found that patients with HCCA tended to have an older age at onset and higher serum levels of CA19-9, CEA, BILT, ALT and BILD. Furthermore, patients with a serum CA19-9 level >233.15 U/ml and CEA level >2.98 ng/ml are more likely to have malignant disease.
肝门部胆管癌（HCCA）缺乏特定的临床表现，与良性疾病仍难以区分。这种区别由于肝门部复杂的解剖结构而变得更加复杂。我们进行了本研究，以评估这些情况的鉴别诊断。2011 年 1 月至 2018 年 10 月期间，65 例患者因疑似 HCCA 接受了切除术。盛景医院的机构审查委员会同意了这项研究，所有参与者在参与研究之前都签署了知情同意书。术后病理分析后，所有患者分为两组：恶性组（54 例 HCCA）和良性组（11 例良性病变）。与良性组相比，恶性组的中位年龄和血清 CA19-9、CEA、ALT、BILT 和 BILD 水平显著更高（P<0.05）。相比之下，两组在性别分布、临床表现、血清 AST 和 ALKP 水平以及影像学发现方面无显著差异。在受试者工作特征曲线分析中，我们确定了 CA19-9 的截断值为 233.15 U/ml 用于鉴别诊断和 CEA 的截断值为 2.98 ng/ml 用于鉴别诊断。HCCA 和良性肝门部病变的鉴别诊断仍然困难。然而，我们发现 HCCA 患者发病年龄较大，血清 CA19-9、CEA、BILT、ALT 和 BILD 水平较高。此外，血清 CA19-9 水平>233.15 U/ml 和 CEA 水平>2.98 ng/ml 的患者更可能患有恶性疾病。
