多项肿瘤标志物检测对原发性肝癌的诊断价值

目的 探讨检测血清甲胎蛋白(AFP)、肿瘤特异性生长因子(TSGF)、糖类抗原125(CA125)和癌胚抗原(CEA)含量对原发性肝癌(PHC)的临床诊断价值.方法 对68例PHC患者、50例良性肝病患者及60例健康对照组的样本,分别用化学发光法测定CA125、生物化学比色定量法测定TSGF、放射免疫法测定AFP和CEA.结果 AFP、TSGF、CA125和CEA指标与健康对照组比较,在良性肝病组中含量有所增高,差异有统计学意义(P<0.01);而各指标在PHC组中的水平与健康对照组、良性肝病组比较,含量明显增高,差异有统计学意义(P<0.01).AFP、TSGF、CA125和CEA单项指标诊断PHC的阳性率均低于联合检测的阳性率,差异有统计学意义(χ2值分别为4.42、17.65、34.40、68.72,P值均小于0.05).单项检测中AFP对诊断PHC的敏感度、阴性预测值和准确度最高,联合检测可使敏感度、阴性预测值和准确度提高到91.2%、93.9%和86.5%.结论 AFP、TSGF、CA125和CEA对肝肿瘤的良恶性辅助诊断及鉴别诊断具有一定应用价值,联合检测可以提高PHC的阳性诊断率.

Diagnostic value of multiple tumor markers detection on primary hepatic carcinoma

Objective To study the value of detection of serum levels of AFP,TSGF,CA125 and CEA in the diagnosis of primary hepatic carcinoma（PHC）.Methods In 68 cases of primary hepatic carcinoma,50 cases of benign liver disease and 60 healthy control samples,serum CA125 was detected by chemiluminescence,TSGF by biochemical colorimetric quantitative determination,AFP and CEA by radioimmunoassay respectively.Results Compared with the healthy control group,serum AFP,TSGF,CA125 and CEA levels in the benign liver disease group were increased with statistical difference（P0.01）;and compared with healthy control group and benign liver disease group,the various indicators in the PHC group were significantly increased with statistical difference（P0.01）.The positive rate in single index of AFP,TSGF,CA125 and CEA for diagnosing PHC was less than that of joint detection,showing statistical difference（χ2=4.42,17.65,34.40,68.72,P0.05）.The single AFP detection had highest sensitivity,negative prediction and accuracy were highest for diagnosing PHC.The combined detection could increase the sensitivity,negative predictive value and accuracy by 91.2%,93.9% and 86.5% respectively.Conclusion AFP,TSGF,CA125 and CEA have certain application value in the auxiliary diagnosis of benign and malignant liver tumor and differential diagnosis.The combined detection can increase the rate of positive diagnosis of PHC.