摘要
Abstract
Objective To investigate the value of ultrasound combined with tumor marker CA19-9 and CEA on the accuracy of early diagnosis of gallbladder cancer. Methods The accuracy of initial diagnosis of primary gallbladder carcinoma was analysed by comparing the preoperative ultrasonography, CA19-9, CEA and postoperative pathological examination. For logistics regression equation, the individual prediction probability val-ues of different examination methods were calculated, and the area under the ROC curve was compared, and the accuracy of the prediction equation was checked by pathological diagnosis. Results There was a high specific-ity but low sensitivity of ultrasound, CA19-9 or CEA in the diagnosis of primary gallbladder cancer. When both B-ultrasound and serum levels of CA19-9 and CEA were positive, the diagnostic sensitivity was 90.0% and the specificity was 92.0% respectively. In addition, the use of combined use of ultrasound and tumor markers was significantly different (P<0.05). The area under ROC curve(AUC) was successively as ultrasound+CA19-9+CEA (0.937), CA19-9+CEA(0.827), ultrasound(0.767)alone. The binary Logistic regression equation was P=1/[1+e-(-4.107+2.677×X1+0.051×X2+0.729×X3)]. AUC of P was 0.368. With a false positive rate of 10%as a condition ,taking P≥0.368 as the cut-off value for forecasting of gallbladder cancer, the sensitivity, specificity and coincidence rate were 82.8%、88.2% and 80.0%,respectively. And there was not any statistical difference between the prediction model and ultrasound combined tumor marker (P>0.05). Conclusion Combination of B-ultrasound and de-termination of serum of CA19-9 and CEA can increase the accuracy of the diagnosis of gallbladder cancer. In addition, the combined forecasting model of gallbladder cancer has a certain clinical value.关键词
胆囊癌/超声/糖类抗原19-9/癌胚抗原/预测模型Key words
Gallbladder neoplasm/ultrasonography/carbohy drate antigen 19-9/carcinoembryonic antigen/forecasting model分类
医药卫生
