摘要
目的探讨红细胞体积分布宽度对胆道良恶性狭窄的诊断价值。方法回顾性分析135例恶性胆道狭窄及53例良性胆道狭窄患者，将2组红细胞体积分布宽度（RDW）值进行对比，进一步分析RDW与胆道狭窄的部位、具体病因的关系，并与传统肿瘤标志物CA19-9、癌胚抗原（CEA）进行相关性检测分析。结果胆道恶性狭窄组54．1％的患者RDW升高，明显高于良性狭窄组的18．9％，差异有统计学意义（P〈0．05）。以RDW〉15．O％为界，发现其诊断恶性胆道狭窄的灵敏度和特异度分别为47％和81％。对于低位胆道梗阻（BismuthⅠ＋Ⅱ），良恶性组间RDW值比较，差异有统计学意义（P〈0．001），恶性组明显升高；对于高位胆道梗阻（Bismuth Ⅲ＋Ⅳ），两者比较差异无统计学意义（P=0．505）。同为良性狭窄或者恶性狭窄时，不同狭窄部位的RDW之间差异无统计学意义（P均〉0．05）。相关性分析显示，RDW值与CA19-9（r=0．099，P：0．201）和CEA（r=0．115，P=0．152）均无明显相关性。CA19-9、CEA和RDW用于诊断恶性胆道狭窄的准确度分别为79％、69％和64％。结论RDW值检测对胆道梗阻的定性诊断具有一定的价值，可作为独立于CA19-9、CEA的生化指标，用于鉴别胆道良恶性肿瘤。
Objective To investigate the diagnostic value of red blood cell distribution to differenti- ate benign biliary stricture （BBS） from malignant biliary stricture （MBS）. Methods RDW and clinical features of biliary stricture lesions in 153 MBS patients were reviewed and compared with those 53 BBS pa- tients. Correlation analyses among RDW, CA19-9 and CEA were also performed. Results RDW in MBS group was significantly higher than that of BBS group （ P 〈 0.05 ）. The positive rates of RDW in MBS and BBS were 54. 1% and 18. 9% respectively, based on the prerequisite that RDW 〉 15% being the diagnostic value （P 〈 0.05）. The sensitivity and specificity of RDW in MBS diagnosis were 47% and 81% respective- ly. For patients with lower stricture （ I and II ）, RDW of MBS was significantly higher than that of BBS （P 〈 0. 001 ） ; while for patients with higher stricture （ 11I and 1V ）, the difference between MBS and BBS was not significant （P = 0. 505）. For both MBS and BBS, there was no significant difference in RDW be- tween strictures of Bismuth typeⅠ,Ⅱ and those of Ⅲ and Ⅳ （ both P 〉 0. 05）. In terms of correlation analy- sis, the RDW values were not positively correlated with CA19-9 （ r = 0. 099, P = 0. 201 ） or CEA （ r = O. 115, P=0. 152）. The diagnostic accuracy of CEA, CA199 and RDW for MBS were 69% , 79% and 64% respectively. Conclusion RDW is a valuable biochemical factor for discriminating MBS and BBS, which is independent of CA199 and CEA.
出处
《中华消化内镜杂志》
2014年第2期76-79,共4页
Chinese Journal of Digestive Endoscopy
关键词
癌胚抗原
胆道疾病
诊断
红细胞体积分布宽度
Carcinoembryonic antigen
Biliary tract diseases
Diagnosis
Red blood cell dis-tribution width
