Value of serum carbohydrate antigeng 19-9 combined with procalcitonin in the diagnosis of acute cholangitis secondary to common bile duct stones

Objective To investigate the value of serum carbohydrate antigen 19-9(CA19-9) combined with procalcitonin(PCT) in the diagnosis of acute cholangitis secondary to common bile duct stones. Methods A retrospective analysis was performed for the clinical data of764 patients with common bile duct stones who were admitted to The Third Affiliated Hospital of Zunyi Medical University from June 2012 to June 2018,and according to the presence or absence of acute cholangitis,they were divided into cholangitis group with 173 patients and non-cholangitis group with 591 patients. The t-test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups. Receiver operating characteristic(ROC) curves were plotted for statistically different indices to calculate the cut-off value,sensitivity,and specificity of each index. Results Compared with the non-cholangitis group,the cholangitis group had significantly higher levels of C-reactive protein(CRP)(78. 24 ± 8. 02 mg/L vs 30. 14 ± 4. 25 mg/L,t =3. 730,P = 0. 038),PCT(2. 25 ± 0. 21 ng/ml vs 0. 21 ± 0. 06 ng/ml,t = 9. 297,P < 0. 001),and CA19-9(87. 52 ± 7. 95 kU/L vs24. 15 ± 3. 87 kU/L,t = 26. 35,P < 0. 001). Serum PCT had an area under the ROC curve(AUC) of 0. 907,a sensitivity of 82. 4%,and a specificity of 86. 1%,serum CA19-9 had an AUC of 0. 825,a sensitivity of 85. 2%,and a specificity of 80. 5%,and serum CRP had an AUC of 0. 643,a sensitivity of 69. 2%,and a specificity of 54. 3%; CRP had no diagnostic value due to an AUC of < 0. 7. Serum PCT combined with CA19-9 had a sensitivity of 97. 11%,a specificity of 98. 65%,a false negative rate of 2. 89%,and a false positive rate of1. 35%. Conclusion Both serum CA19-9 and PCT have an important value in predicting acute cholangitis secondary to common bile duct stones,and combined measurement of serum CA19-9 and PCT has significant increases in specificity and sensitivity and can thus be used as a predictive indicator for acute cholangitis.