Study The Trend Of Bile And Serum CA19-9and CA242in Canceration Of Congenital Biliary Dilatation

Objective:To analyze the levels of the serum and bile tumor markers CA19-9, CA242in patients with congenital biliary dilatation, and contrast with cholangiocarcinoma, and analyze the values of tumor marker detection.Methods:Thirty-three patients with congenital biliary dilatation, fourteen patients with cholangiocarcinoma and fifteen patients with cholelithiasis in the first affiliated hospital of Kunming medical university were selected, the samples of their serum and bile were collected, and the values of serum and bile tumor markers CA19-9, CA242were detected before treatment. And study the expression of protein Bcl-2, P53in congenital biliary dilatation and cholangiocarcinoma.Result:The level of bile CA19-9and bile CA242was higher than the level of serum CA19-9and serum CA242in the congenital biliary dilatation group, the cholangiocarcinoma group and the cholelithiasis group. The difference was statistically significant(p<0.05). The level of bile CA19-9, CA242and serum CA19-9, CA242in the congenital biliary dilatation group were higher than that of cholelithiasis group. The difference was statistically significant(p<0.05). The level of serum CA19-9, CA242in congenital biliary dilatation group were lower than that of cholangiocarcinoma group. The difference was statistically signiftcant(p<0.05). But the level of bile CA19-9, CA242in congenital biliary dilatation group were lower than that of cholangiocarcinoma group. The difference was no statistically significant(p>0.05). The Youden index of bile CA19-9was higher than serum CA19-9, so the diagnostic performance and value of bile CA19-9was higher than serum CA19-9. Testing the correlation between serum CA19-9and bile CA19-9with spearman. Think of it has correlation between serum CA19-9and bile CA19-9in congenital biliary dilatation (P<0.05). The correlation index was0.421, which of being positively correlated. But the Youden index of bile CA242was lower than bile CA19-9, higher than serum CA242. Testing the correlation between serum CA242and bile CA242with spearman. Think of it has no correlation between serum CA19-9and bile CA19-9(P>0.05). By immunohistochemistry, we were not detected P53protein in congenital biliary dilatation examined. So it is low value to detect p53in congenital biliary dilatation. We detected Bcl-2protein in17(51.5%) of the33congenital biliary dilatation examined. Combination of the correlation analysis in the serum and bile CA19-9, CA242and Bcl-2protein in the congenital biliary dilatation, think the serum and bile CA19-9, CA242and Bel2protein were positively correlated.Conclusion:1.When the serum levels of CA19-9is more than47.5U/mL, serum CA242is greater than4.2U/mL for evaluation of congenital bile duct expansion trend of cancer have diagnostic value;When the bile CA19-9is more than20010U/mL, bile CA242is more than1254U/mL canceration tendency for the evaluation of congenital bile duct expansion have diagnostic value.2. The longer the disease duration, the higher tumor markers in the serum and bile content, concluded that it has the possibility of canceration tendency.3.The Youden index of Bile CA19-9is the highest in diagnosing congenital biliary dilatation. And the Youden index of Bile CA242is also higher in diagnosing congenital biliary dilatation. Both have great value in diagnosing whether congenital biliary dilatation turn into the cholangiocarcinoma.4. Tumor suppressor gene p53were not expressed in congenital bile duct expansion, but high expression in bile duct carcinoma; Congenital bile duct expansion in the BCL-2protein expression is lower than the bile duct carcinoma tissue of expression.