3种肿瘤标记物联合血清 MMP-7及胆汁MMP-7检测对胆管癌的临床意义

摘要

Objective:To evaluate the clinical significance of combined detection of serum CA1 9-9,CA125,CEA,MMP-7 and bile MMP-7 in patients with cholangiocarcinoma.Methods:The serum level of CA1 9-9,CA125,CEA,MMP-7 and bile level of MMP-7 in 58 patients with cholangiocarcinoma (experimental group)and 60 patients with bile duct benign disease(control group)were detected by enzyme linked immunosorbent assay and correlation analysis in the general surgery department of the armed police Border Defense Corps Hospital of Inner Mongol from March 2012 to May 2013.Results:Compared to control group,the levels of total bilirubin,direct bilirubin,glutamic oxalacetic transaminase,γ-glutamyl transpeptidase,alkaline phosphatase increased and there was statistically significant difference (P <0.05). However,there was no statistically significant difference (P >0.05)of the level of glutamic-pyruvic transaminase be-tween the two group.Then the levels of CA1 9-9,CA125,CEA,MMP-7 and bile MMP-7 in patients with cholangiocar-cinoma higher than patients with bile duct benign disease and there was statistically significant difference (P <0.05). The logistic regression analysis showed that the levels of serum CA1 9-9,CA125 and MMP-7 of the two groups posi-tively related with bile duct carcinoma diagnosis (P <0.05),but bile MMP-7 level has no related with serum CEA level (P >0.05).The level of MMP-7 of serum and bile have no related with biochemical criterion (P >0.05).Conclusion:The combined detection of serum CA1 9-9,CA125,CEA,MMP-7 and bile MMP-7 were helpful to the efficiency of cholangiocarcinoma diagnosis and have the higher clinical reference value.%目的：：探讨胆管癌患者血清中糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、癌胚抗原(CEA)、基质金属蛋白酶(MMP-7)和胆汁 MMP-7水平的变化及其临床意义。方法：选取2012年3月—2013年5月，内蒙古边防总队医院经手术和病理证实胆管癌的患者58例作为胆管癌组，另选同期该院收治的胆道良性疾病患者60例作为良性对照组。采用酶联免疫吸附法(ELISA)检测研究人群的血清 CA19-9、CA125、CEA、MMP-7及胆汁 MMP-7水平变化情况，并进行各指标间的相关性分析。结果：与良性对照组患者相比，胆管癌组患者的总胆红素、直接胆红素、谷草转氨酶、γ-谷氨酰转肽酶、碱性磷酸酶水平增高，差异有统计学意义(P <0.05)，而谷丙转氨酶水平差异无统计学意义(P >0.05)；胆管癌组患者血清 CA19-9、CA125、CEA、MMP-7及胆汁 MMP-7水平较良性对照组增高，差异有统计学意义(P <0.05)；Logistic 回归分析，结果显示，两组人群 CA19-9、CA125、血清 MMP-7与胆管癌诊断呈现正相关(P <0.05)；而胆汁 MMP-7与血清 CEA 水平无相关性(P >0.05)；血清 MMP-7及胆汁 MMP-7表达水平与上述生化指标均无相关性(P >0.05)。结论：联合检测血清 CA19-9、CA125、CEA、MMP-7及胆汁 MMP-7水平能提高胆管癌诊断的效能，有较高的临床参考价值。