Expression And Clinical Significance Of The The RCAS1&TuM2-PK In The Serum Of Patients With Cholangiocarcinoma

Objective:1. To analyze the diagnostic value of RCAS1and TuM2-PK in diagnosing cholangiocarcinoma by observing the expression of them in the human serum of patients with cholangiocarcinoma, bile duct stone patients and healthy controls;2. To explore the correlation between the RCAS1and TuM2-PK expression and cholangiocarcinoma patients’ clinicopathological parameters, bilirubin, transaminase and observe the serum expression changes of RCAS1and TuM2-PK before and after surgery;3. to compare with CA19-9and evaluate the three joint detection of RCAS1, TuM2-PK and CA19-9in diagnosis of cholangiocarcinoma.Method:the expression of RCAS1and TuM2-PK were detected in serums of94cases patients with cholangiocarcinoma,53cases patients with bile duct stones and40cases of healthy people by ELISA (double antibody sandwich method) respectively, and the blood test of patients with cholangiocarcinoma was made once again in4weeks after radical operation. According to the experimental purposes, the experimental and clinical data collected and collated were analyzed statistically by using Excel2007software and SPSS17.0software. Results:1. The RCAS1positive rates and mean serum concentrations of bile duct cancer patients (72.34%,72.62±29.97U/L) were higer than the common bile duct stone patients (11.32%,39.88±14.43U/L)and healthy controls (2.50%,32.61±10.18U/L); the TuM2-PK positive rates and mean serum concentrations of bile duct cancer patients (80.85%,21.51±8.13U/L) were higher the common bile duct stone patients (13.2%,11.63±3.06U/L)and healthy controls (5.00%,10.10±2.01U/L), with significant differences (P<0.05). The sensitivity and specificity of RCAS1in diagnosing cholangiocarcinoma were72.34%and92.47%,80.85%and90.32%in TuM2-PK, the combined detection of the two were85.11%and96.77%. Joint detection sensitivity is higher than RCAS1tested independently, with statistically differences (P<0.05).2. The RCAS1expression of bile duct cancer patients in tumor size>2cm group was higher than it in the tumor<2cm group, III+IVperiod group was higher than Ⅰ+Ⅱ period group, with lymph node metastasis group was higher than without lymph node metastasis group, with tissues and organs metastasis group was higher than without tissues andorgans metastasis group, with statistically differences (P<0.05). The TuM2-PK expression of bile duct cancer patients in low differentiation group was higher than it in high-mediocre differentiation group, with lymph node metastasis group was higher than without lymph node metastasis group, with significant differences (P<0.05).3. By analyzing the correlation between the expression of RCAS1and TuM2-PK and cholangiocarcinoma patients’clinicopathological parameters, bilirubin, transaminase, we found that in the common bile duct stone group RCAS1expression has nothing to do with bilirubin and transaminase (P>0.05); in the cholangiocarcinoma group RCAS1expression has something to do with bilirubin (P<0.05), and nothing to do with transaminase (P>0.05). In further statistical analysis, patients with cholangiocarcinoma and bile duct stones patients were re-grouped according to elevated bilirubin or bilirubin normal, RCAS1average concentration within the two group, there was no statistically significant difference (P>0.05). TuM2-PK expression has nothing to do with bilirubin and transaminase (P>0.05).4. For underwent radical surgery in58cases of patients with cholangiocarcinoma, the RCAS1positive rates and mean serum concentrations before surgery (70.69%,72.62±29.97U/L) were higher than those after surgery (37.39%,45.05±21.47U/L), the TuM2-PK positive rates and mean serum concentrations before surgery (79.31%,21.51±8.13U/L) were higher than those after surgery (43.10%,13.44±6.50U/L), with significant differences (P<0.05). 5. The CA19-9positive rates and median serum concentrations of bile duct cancer patients (71.28%,169.80KU/L) were higher than the common bile duct stone patients (18.87%,13.09KU/L) and healthy controls (2.50%,6.58KU/L), patients with bile duct stones were higher than healthy people, with statistically differences (P<0.05).6. The sensitivity and specificity of RCAS1, TuM2-PK, CA19-9combined detection and diagnosis of cholangiocarcinoma were8723%,97.85%, the sensitivity and specificity of independent detection of RCAS1was72.34%,92.47%; TuM2-PK was80.85%,90.32%; CA19-9was71.28%,88.17%. Compared the sensitivity and specificity of RCAS1&TuM2-PK and CA19-9, there was no significantly statistical differences (P>0.05), the sensitivity of combined detection was higher than that of RCAS1and CA19-9alone, the specificity was higher than that of TuM2-PK and CA19-9alone (P<0.05).Conclusion:1. The levels of RCAS1and TuM2-PK in serum of cholangiocarcinoma patients was significantly higher than gallstone patients and healthy people. The sensitivity of combined detection of RCAS1, and TuM2-PK was superior to RCAS1.2. The serum expression of RCAS1in cholangiocarcinoma patients was higher as the tumor size was larger, the clinical stage was higher and the patients have lymph node, tissues and organs metastasis, The serum expression of TuM2-PK in cholangiocarcinoma patients was higher as the pathological grade was lower and the patients have lymph node metastasis.3. The postoperative expression of RCAS1&TuM2-PK in patients with cholangiocarcinoma was lower than the preoperative one.4. The sensitivity and specificity of cholangiocarcinom diagnosis had no significant difference between CA19-9detection and combined detection of RCAS1and TuM2-PK. The sensitivity of three joint detection was superior to RCAS1and CA19-9respectively, and the specificity was superior to TuM2-PK and CA19-9respectively.