The Value Of Combined Detection Of CA19-9,CEA And IBIL In Serum In Differential Diagnosis Of Cholangiocarcinoma

Objective: To compare the value of differential diagnosis of cholangiocarcinoma of carbohydrate antigen 19-9,carcinoembryonic antigen and indirect bilirubin,while they were detedcted separately and jointly.Methods : The clinical data of 376 patients with bile duct disease were reviewed,57 were divided into cholangiocarcinoma group and 319 were divided into benign bile duct lesion group.Tumor markers,such as alpha fetoprotein,CA19-9,CEA,carbohydrate antigen 125 and biochemical indexes,such as total bilirubin,direct bilirubin,IBIL,alanine transaminase,r-Glutmayl ransferase,alanine transaminase,aspartie acid anlinotransferase were collected.Single factor analysis and logistics regression analysis were used to determine the influencing factors and independent influencing factors.Analyzing the sensitivity,specificity and other relevant data of independent influencing factors of the single and combined detection.Results: The result of single factor analysis showed that there was no significant difference in gender(P=0.083),age(P=0.119),AFP(P=0.167),TBIL(P=0.059),DBIL(P=0.432),r-GT(P=0.080),ALT(P=0.186)and AST(P=0.082)between the two groups(P>0.05).The differences among CA19-9(P=0.000),CEA(P=0.000),CA125(P=0.000),IBIL(P=0.000)and ALP(P=0.006)were statistically significant(P<0.05),indicating that CA19-9,CEA,CA125,IBIL and ALP are influencing factors of cholangiocarcinoma.And the result of logistics regression analysis showed that the differences among CA19-9(P=0.046),CEA(P=0.000)and IBIL(P=0.000)were statistically significant(P<0.05),indicating that CA19-9,CEA and IBIL were independent influencing factors for cholangiocarcinoma.The benign bile duct lesions group were control group,the sensitivity of the combined detection of CA19-9 + IBIL+ CEA in the cholangiocarcinoma group was 89.5%,and the area under the ROC curve of the subject was 0.813;The sensitivity,specificity,accuracy and AUC of IBIL+CEA were 70.2%,81.2%,79.5% and 0.809,respectively.Conclusions: The combined detection of CA19-9,CEA and IBIL is better than the detection of single indicator,the combined detection has more clinical guiding significance in differential diagnosis of cholangiocarcinoma.