首都医科大学学报 ›› 2023, Vol. 44 ›› Issue (6): 990-998.doi: 10.3969/j.issn.1006-7795.2023.06.014

• 消化系统疾病诊疗技术与进展 • 上一篇    下一篇

十二指肠乳头肿瘤患者的临床特征分析及其对肿瘤进展期的诊断价值

乔新伟#,邱煜婷#,李鹏,吴静*,张澍田   

  1. 首都医科大学附属北京友谊医院消化内科国家消化系统疾病临床医学研究中心,北京 100050
  • 收稿日期:2023-08-15 出版日期:2023-12-21 发布日期:2023-12-20
  • 通讯作者: 吴静 E-mail:wujing36youyi@ccmu.edu.cn
  • 基金资助:
    北京市医院管理中心消化内科学科协同发展中心重点项目(XXZ015),首都临床诊疗技术研究及转化应用项目(Z211100002921028),首都卫生发展科研专项项目(CFH2022-2-2025),北京市通州区科技计划项目(KJ2023CX016)。

Analysis of clinical characteristics of patients with duodenal papilla neoplasms and the diagnostic value for advanced carcinoma

Qiao Xinwei#, Qiu Yuting#, Li Peng,Wu Jing*,  Zhang Shutian   

  1. Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing 100050, China
  • Received:2023-08-15 Online:2023-12-21 Published:2023-12-20
  • Supported by:
    This study was supported by the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority (XXZ015), the Beijing Science and Technology Program (Z211100002921028), the Capital's Funds for Health Improvement and Research (CFH2022-2-2025),  Tongzhou Science and Technology Program (KJ2023CX016)。

摘要: 目的  本研究旨在探索对鉴别诊断十二指肠乳头肿瘤(duodenal papilla neoplasms,DPNs)早癌与进展期癌有价值的临床指标。方法  纳入95例DPNs患者的一般情况、实验室化验以及包括消化内镜等影像学检查的数据,通过LASSO(least absolute shrinkage and selection operator)回归初步筛选预测因素,再通过单因素及多因素Logistic分析确定进展期DPNs的独立危险因素。结果  对本研究中的95例DPNs患者,采用LASSO回归筛选出症状、糖类抗原125(carbohydrate antigen 125, CA125)、CA50、γ-谷氨酰基转移酶(γ-glutamyltransferase, GGT)、总胆红素(total bilirubin, TBIL)、血红蛋白(hemoglobin, Hb)等6项指标进行Logistic回归分析,最终确定出现临床症状、GGT以及CA50升高这3项指标是DPNs进入进展期的独立预测因素(P<0.05)。结论  出现黄疸等临床症状以及GGT、CA50明显升高可能是比影像学检查更有价值的诊断进展期DPNs的独立危险因素。

关键词: 十二指肠乳头肿瘤, 肿瘤标志物, 进展期癌, 早癌

Abstract: Objective  To explore valuable indicators for the differential diagnosis of early and advanced duodenal papilla neoplasms (DPNs).Methods  Data of general conditions, laboratory tests and imaging examinations including digestive endoscopy were collected from patients with DPNs. LASSO (least absolute shrinkage and selection operator) regression was used to screen predictive factors. Univariate and multivariate Logistic analysis were used to determine the independent risk factors for advanced DPNs. ResultsA total of 95 DPNs patients were included in this study. Symptoms, carbohydrate antigen 125 (CA125), CA50, γ-glutamyltransferase (GGT),  total bilirubin (TBIL) and  hemoglobin (Hb) were screened out by LASSO regression for Logistic regression analysis. Finally, clinical symptoms, elevated GGT and CA50 were validated to be independent predictors of progressive DPNs (P<0.05). Conclusion  The clinical symptoms such as jaundice, significantly increased GGT and CA50 are independent risk factors, and it may be more valuable than imaging examination in the judgment of DPNs as advanced carcinoma.

Key words: duodenal papilla neoplasms, biomarker of tumor, advanced stage carcinoma, early-stage carcinoma

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