Diagnose Intrahepatic Bile Duct Stones With Early Intrahepatic Cholangiocarcinoma By Combining CA199, CEA, CA50 And ALP And Magnetic Resonance Imaging

Objective:1.Observation and analysis of clinical symptoms, laboratory examination and imaging examination results of two groups of patients of Hepatolithasis-associated intrahepatic cholangiocarcinoma(HICC) and Intrahepatic cholangiocarcinoma(ICC);2. sensitivity, specificity and accuracy of single and combined a variety of serologic indicator for diagnosing Hepatolithasis-associated intrahepatic cholangiocarcinoma;3.compare diagnosis effect and the qualitative diagnosis coincidence rate of ultrasound, CT or MRI in the diagnosis of Hepatolithasis-associated intrahepatic cholangiocarcinoma;4. combine the methods of current diagnosis, mutually make up respective defects and explore the method of improving preoperative diagnosis accuracy of intrahepatic cholangiocarcinoma.Methods:Retrospectively analyze clinical material of 36 cases of Hepatolithasis-associated intrahepatic cholangiocarcinoma (HICC) patients and 118 cases of Intrahepatic duct stone (IHDS) patients cured in second affiliated hospital of kunming medical university. All of the 154 patients were performed blood biochemistry, serum tumor markers, magnetic resonance imagining (MRI and MRCP) and pathological examination. The results were compared and analyzed.Results:1.abdominal pain discomfort in Hepatolithasis-associated intrahepatic cholangiocarcinoma is multiple symptoms, three typical Charcot syndrome are rare; On the gender distribution, intrahepatic bile duct stones is more found in women, on the contrary, Hepatolithasis-associated intrahepatic cholangiocarcinoma is more found in men (P<0.05); Abdominal pain and fever in patients of Hepatolithasis-associated intrahepatic cholangiocarcinoma are higher than that of Intrahepatic bile duct stone patients (P<0.05);2. when alkaline phosphatase (ALP) is more than 169U/L, there was significant difference between two groups (P<0.05);3. MRI diagnosis coincidence rate was 86.1% comparing with pathology results. MRI qualitative diagnosis coincidence rate is more higher than ultrasound and CT. Compared with the ultrasound, differences between the two groups were statistically significant(P<0.05); compared with CT, there was no statistically significant difference (P>0.05).4. In combined diagnosis of HICC, the accuracy of combining CA199, CEA, CA50 and ALP is 88.6%; the accuracy of combining MRI and MRCP is 90.2%; the checking accuracy of magnetic resonance imaging combined multiple serological indicator is 95.5%.Conclusion:1. On the gender distribution, intrahepatic bile duct stones is more found in women, on the contrary, Hepatolithasis-associated intrahepatic cholangiocarcinoma is more found in men;Abdominal pain and fever in patients of Hepatolithasis-associated intrahepatic cholangiocarcinoma are higher than that of Intrahepatic bile duct stone patients;2. the rising of ALP in the diagnosis of HICC is of certain guiding significance; sensitivity, specificity and accuracy of combining serum CA-199, CEA, CA50 and ALP is higher than of single tumor marker detection;3. HICC qualitative diagnosis coincidence rate of Ultrasound is low, not as the preferred examination method. HICC qualitative diagnosis coincidence rate of magnetic resonance imaging (MRI) is higher, and MRI has important reference value in preoperative diagnosis of HICC.4.combining CA199, CEA, CA50, ALP and magnetic resonance imaging can effectively improve the preoperative diagnostic rate of HICC.