Liu Yanguo, Wu Yanfang, He Shujie
Department of Hepatobiliary and Pancreatic Surgery, East Hospital of Yantai Mountain Hospital, Yantai, China.
Am Surg. 2025 Apr;91(4):608-613. doi: 10.1177/00031348241312119. Epub 2025 Jan 4.
ObjectiveThis study was aimed at ascertaining the application value of abnormal prothrombin (PIVKA-II) and carbohydrate antigen 125 (CA125) in gallbladder cancer (GBC) diagnosis.MethodsA total of 70 GBC patients, 70 patients with benign gallbladder diseases (gallbladder stones and gallbladder polyps), and 70 normal health examination people were selected as the malignant, benign, and normal groups, respectively. The differences in serum levels and positive rates of PIVKA-II and CA125 were compared. The correlation between serum PIVKA-II and CA125 levels and different clinicopathological characteristics (TNM stage and differentiation degree) of GBC patients was analyzed. The receiver operating characteristic curve was plotted to evaluate the diagnostic value of serum PIVKA-II and CA125 for GBC, and sensitivity, specificity, and Youden's index were calculated.ResultsSerum PIVKA-II and CA125 levels and positive rates of patients in the malignant group were higher vs those in the benign and normal groups. Gallbladder cancer patients at stages III-IV had higher serum PIVKA-II and CA125 levels than those at stages I-II, and poorly differentiated GBC patients had higher serum PIVKA-II and CA125 levels than moderately differentiated and well-differentiated GBC patients. The AUC of serum PIVKA-II and CA125 alone and in combination were 0.771, 0.789, and 0.866, respectively, and the AUC of the two combined was higher vs that of the two alone.ConclusionSerum PIVKA-II and CA125 levels in GBC patients are increased and have significant clinical application value in the diagnosis of GBC.
目的
本研究旨在确定异常凝血酶原(PIVKA-II)和糖类抗原125(CA125)在胆囊癌(GBC)诊断中的应用价值。
方法
选取70例GBC患者、70例良性胆囊疾病(胆囊结石和胆囊息肉)患者以及70例健康体检者,分别作为恶性组、良性组和正常组。比较PIVKA-II和CA125的血清水平及阳性率差异。分析GBC患者血清PIVKA-II和CA125水平与不同临床病理特征(TNM分期和分化程度)之间的相关性。绘制受试者工作特征曲线,评估血清PIVKA-II和CA125对GBC的诊断价值,并计算敏感性、特异性和约登指数。
结果
恶性组患者的血清PIVKA-II和CA125水平及阳性率高于良性组和正常组。III-IV期胆囊癌患者的血清PIVKA-II和CA125水平高于I-II期患者,低分化GBC患者的血清PIVKA-II和CA125水平高于中分化和高分化GBC患者。血清PIVKA-II和CA125单独及联合检测的AUC分别为0.771、0.789和0.866,两者联合检测的AUC高于单独检测。
结论
GBC患者血清PIVKA-II和CA125水平升高,在GBC诊断中具有重要临床应用价值。