effect of ultrasound combined with determination of ca19-9 and hs-crp on the accuracy of early diagnosis of gallbladder cancer

Objective 　To investigate the value of ultrasound combined with tumor marker CA19-9 and high sensitivity C reactive protein (hs-CRP) on the accuracy of early diagnosis of gallbladder cancer. Methods 　Ninety-five patients with pathologically confirmed primary gallbladder cancer who received cholecystectomy from Jan. 2008 to Jan. 2013 in our hospital were included in the study. The study also included 51 patients with benign cystic lesions and 51 healthy adults. In all patients, results of pathological examination, B-ultrasound, serum CA19-9 and hs-CRP detection were obtained. In all the healthy adults gallbladder diseases were ruled out, but all of them received serum CA19-9 and hs-CRP determination. Results 　Of 95 patients with primary gallbladder cancer, B-ultrasound showed nodules in the gallbladder lumen in 31, tumor mass in 40, and thickened wall in 24. Histological examination showed adenocarcinoma in 87 cases, adenosquamous carcinoma in 6, and squamous carcinoma in 2. There was a statistical difference in hs-CRP and CA19-9 levels between the groups (P<0.05), and the highest level appeared in gallbladder cancer group. There was a high sensitivity but low specificity of CA19-9 or hs-CRP in the diagnosis of primary gallbladder cancer. The sensitivity and specificity were 74.7% and 75.0% when primary gallbladder cancer was diagnosed with B-ultrasound. The positive values of CA19-9 and hs-CRP were ≥100U/ml and ≥6mg/L respectively, when they were combined with B-ultrasound as a single serology factor. When both B-ultrasound and serum levels of CA19-9 and hs-CRP were positive, the diagnostic sensitivity and specificity were 71.6% and 84.4% respectively. When B-ultrasound or serum CA19-9 and hs-CRP were positive, the diagnostic sensitivity and specificity were 98.9% and 66.7% respectively. Conclusions 　Combination of B-ultrasound and determination of serum of CA19-9 and hs-CRP can improve the accuracy of the diagnosis of gallbladder cancer. DOI: 10.11855/j.issn.0577-7402.2014.03.11