Wang Tixue,Feng Lin,Sun Mingxuan,et al.Application value of multi-index combined detection in early differential diagnosis of choledochal cyst and cystic biliary atresia[J].Journal of Clinical Pediatric Surgery,,():1155-1159.[doi:10.3760/cma.j.cn101785-202310018-009]
Application value of multi-index combined detection in early differential diagnosis of choledochal cyst and cystic biliary atresia
- Keywords:
- Choledochal Cyst; Cystic Biliary Atresia; gamma-Glutamyltransferase; Aspartate Aminotransferase; Alanine Aminotransferase; Total Bile Acid; Direct Bilirubin; Total Bile Acid; Diagnosis; Differential
- Abstract:
- Objective To explore the application value of biochemical indicators and combined multi-index detection in an early differential diagnosis of choledochal cyst (CC) and cystic biliary atresia (CBA). Methods A retrospective analysis was conducted on the clinical data of 99 infants under 45 days of age with hepatic hilar cysts,treated from January 2013 to December 2022 at the Pediatric Surgery Department of Jining Medical University Affiliated Hospital and General Surgery Department of Capital Institute of Pediatrics Affiliated Children’s Hospital.Based upon cholangiographic and pathological results,they were assigned into two groups of CBA and CC.The differences in biochemical parameters between two groups were compared.And the diagnostic effectiveness of single biochemical parameters and multi-index co-prediction models was analyzed by receiver operating characteristic curve (ROC). Results CBA group was composed of 37 cases (11 males and 26 females) with a median operative age of 26(18,37) days.And CC group included 62 cases (14 males and 48 females) with a median operative age of 23(13,35) days.No statistically significant inter-group differences existed in gender distribution or operative age (P>0.05).Preoperative level of γ-glutamyl transferase (GGT) were 456.2(294.0,647.5) U/L in CBA group and 385.6(220.9,611.2) U/L in CC group;aspartate aminotransferase (AST) level was 85.2(42.9,145.1) U/L in CBA group and 57.1(36.6,105.5) U/L in CC group;alanine aminotransferase (ALT) was 45.6(16.6,91.2) U/L in CBA group and 29.4(15.2,59.3) U/L in CC group.The inter-group differences were not statistically significant (P>0.05).However,total bilirubin (TBIL) was 191.8(156.4,227.1)μmol/L in CBA group and 152.5(104.3,200.6)μmol/L in CC group;direct bilirubin (DBIL) 66.7(41.0,97.1)μmol/L in CBA group and 47.3(21.8,70.8) μmol/L in CC group;total bile acid (TBA) 91.4(62.1,114.8)μmol/L in CBA group and 61.9(17.5,91.1)μmol/L in CC group.The inter-group differences were statistically significant (P<0.05).The areas under the ROC curve for TBIL,DBIL,TBA and weighted/unweighted prediction model were 0.658,0.677,0.712,0.752 and 0.782,respectively. Conclusions TBA,TBIL and DBIL have some values in the differential diagnosis of CC and CBA.And co-detection of multiple parameters offers a higher detection performance for facilitating an early postnatal differential diagnosis of CBA and CC.
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Memo
收稿日期:2023-10-11。
基金项目:中国医学科学院创新单元(2021RU015);首都临床诊疗技术研究及示范应用(Z191100006619002)
通讯作者:孙劲松,Email:sjs228@163.com