检验医学与临床2025，Vol.22Issue(7)：869-873,5.DOI:10.3969/j.issn.1672-9455.2025.07.002
PIVKA-Ⅱ联合CA199、VEGF在胆囊癌诊断中的价值分析
The value of PIVKA-Ⅱ combined with CA199 and VEGF in diagnosis of gallbladder cancer
摘要
Abstract
Objective To explore the value of serum abnormal prothrombin(PIVKA-Ⅱ),carbohydrate an-tigen 199(CA199)and vascular endothelial growth factor(VEGF)detection in the diagnosis of gallbladder cancer(GBC)patients.Methods A total of 149 patients with GBC admitted to the First Affiliated Hospital of Air Force Military Medical University from August 2022 to March 2024 were selected in the GBC group.Ad-ditionally,199 patients with gallstones were selected in the benign gallbladder disease group.During the same period,197 healthy individuals were selected as the healthy control group.Measure and analyze the levels of PIVKA-Ⅱ,CA199,VEGF and total bilirubin(TBIL)in each group,analyze the correlation between PIVKA-Ⅱ,CA199,VEGF and TBIL,jaundice grading in GBC patients,and draw receiver operating characteristic(ROC)curve to analyze the diagnostic efficacy of individual and combined detection of various indicators for GBC.Results The levels of PIVKA-Ⅱ,CA199,VEGF and TBIL in the GBC group were significantly higher than those of the benign gallbladder disease group and healthy control group,the differences were statistically significant(P<0.05).The levels of CA199 and VEGF in the benign gallbladder disease group were signifi-cantly higher than those in the healthy control group,the differences were statistically significant(P<0.05).The PIVKA-Ⅱ,CA199,VEGF levels in GBC patients correlated positively with TBIL level(P<0.05).The levels of PIVKA-Ⅱ and CA199 in GBC patients correlated positively with jaundice grading(P<0.05).The PIVKA-Ⅱ,CA199 and VEGF levels of patients with TBIL≤34.2 μmol/L in the GBC group were significantly higher than those of patients with TBIL≤34.2 μmol/L in the benign gallbladder disease group and the health-y control group,the differences were statistically significant(P<0.05).The levels of CA199 and VEGF of patients with TBIL≤34.2 μmol/L in the benign gallbladder disease group were significantly higher than those of patients with TBIL≤34.2 μmol/L in the healthy control group,the differences were statistically significant(P<0.05).GBC patients were divided into a low-level TBIL group and a high-level TBIL group.The PIVKA-Ⅱ,CA199 and VEGF levels in the high-level TBIL group were significantly higher than those in the low-level TBIL group,the differences were statistically significant(P<0.05).The area under the curve(AUC)for the combined detection of PIVKA-Ⅱ,CA199 and VEGF in the diagnosis of GBC was 0.830,which was signifi-cantly larger than the AUC for individual diagnosis(P<0.05).Conclusion In GBC patients with or without high TBIL level,serum PIVKA-Ⅱ,CA199 and VEGF levels elevate significantly.The combined detection of PIVKA-Ⅱ,CA199 and VEGF can improve the sensitivity and specificity of GBC diagnosis,but the combined detection of PIVKA-Ⅱ and VEGF is more economical while ensuring high sensitivity and specificity.关键词
胆囊癌/异常凝血酶原/糖类抗原199/血管内皮生长因子/总胆红素Key words
gallbladder cancer/abnormal prothrombin/carbohydrate antigen 199/vascular endothe-lial growth factor/total bilirubin分类
临床医学引用本文复制引用
陈健康,刘家云..PIVKA-Ⅱ联合CA199、VEGF在胆囊癌诊断中的价值分析[J].检验医学与临床,2025,22(7):869-873,5.基金项目
陕西省重点研发计划项目(2021ZDLSF06-06). （2021ZDLSF06-06）
