高胆汁 CYFRA 21-1 浓度和胆汁与血清比值能可靠地区分由胆管癌引起的恶性胆道梗阻。

High Bile Titer and High Bile to Serum Ratio of CYFRA 21 - 1 Reliably Discriminate Malignant Biliary Obstruction Caused by Cholangiocarcinoma.

机构信息

Department of PancreatoBiliary Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, 510080, China.

Department of Clinical Laboratory, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China.

出版信息

J Gastrointest Cancer. 2024 Jun;55(2):800-808. doi: 10.1007/s12029-024-01023-9. Epub 2024 Jan 27.

DOI:10.1007/s12029-024-01023-9

PMID:38280173

Abstract

INTRODUCTION

Previously we demonstrated that elevated serum CYFRA 21 - 1 is a reliable diagnostic and prognostic biomarker for biliary tract cancers. This study aims to explore the diagnostic performance of bile CYFRA 21 - 1 (bCYFRA 21 - 1) in discriminating malignant biliary obstruction (MBO) caused by cholangiocarcinoma (CCA).

METHODS

77 CCA patients ((17 intrahepatic CCA (iCCA), 49 perihilar CCA (pCCA) and 11 distal CCA (dCCA)) and 43 benign patients with biliary obstruction were enrolled. Serum and bile levels of CYFRA 21 - 1, carcinoembryonic antigen (CEA) and carbohydrate antigen 19 - 9 (CA19-9) were quantified. Diagnostic performances of these biomarkers were estimated by receiver operator characteristic curves. Subgroups analysis of these tumor markers among CCA subtypes was performed.

RESULTS

High bCYFRA 21 - 1 (cut-off value of 59.25 ng/mL with sensitivity of 0.889 and specificity of 0.750) and high bile to serum ratio of CYFRA 21 - 1 (b/sCYFRA 21 - 1, cut-off value of 31.55 with sensitivity of 0.741 and specificity of 0.778) achieved better diagnostic performance than any other biomarker in discriminating MBO. Subgroup analysis revealed that bCYFRA 21 - 1 was significantly elevated in all CCA subtypes; moreover b/sCYFRA 21 - 1 was upregulated in pCCA and dCCA (the mean b/sCYFRA 21 - 1 of pCCA was highest among CCA subtypes: 57.90, IQR 29.82-112.27).

CONCLUSIONS

Both high biliary CYFRA 21 - 1 and high bile to serum ratio of CYFRA 21 - 1 were reliable diagnostic biomarkers for MBO caused by CCA.

摘要

简介

此前我们证实，血清 CYFRA 21-1 升高是胆道癌的可靠诊断和预后生物标志物。本研究旨在探讨胆汁 CYFRA 21-1（bCYFRA 21-1）在鉴别由胆管癌（CCA）引起的恶性胆道梗阻（MBO）中的诊断性能。

方法

纳入 77 例 CCA 患者（17 例肝内 CCA（iCCA）、49 例肝门部 CCA（pCCA）和 11 例远端 CCA（dCCA））和 43 例良性胆道梗阻患者。定量检测血清和胆汁中 CYFRA 21-1、癌胚抗原（CEA）和糖链抗原 19-9（CA19-9）的水平。通过受试者工作特征曲线评估这些生物标志物的诊断性能。对这些肿瘤标志物在 CCA 亚型中的亚组分析进行了分析。

结果

高 bCYFRA 21-1（截断值为 59.25ng/mL，灵敏度为 0.889，特异性为 0.750）和高胆汁与血清 CYFRA 21-1 比值（b/sCYFRA 21-1，截断值为 31.55，灵敏度为 0.741，特异性为 0.778）在鉴别 MBO 方面优于其他任何生物标志物。亚组分析显示，所有 CCA 亚型的 bCYFRA 21-1 均明显升高；此外，pCCA 和 dCCA 的 b/sCYFRA 21-1 升高（pCCA 中各 CCA 亚型的平均 b/sCYFRA 21-1 最高：57.90，IQR 29.82-112.27）。