甲胎蛋白、癌胚抗原和糖类抗原199联合检测在原发性肝癌诊断中的应用研究

目的探讨血清甲胎蛋白（AFP）、癌胚抗原（CEA）和糖类抗原199（CA199）联合检测在原发性肝癌诊断中的应用价值。方法选取我院2009年1月～2012年6月收治的原发性肝癌患者153例为观察组，经临床病理诊断分为两组，病理诊断为良性患者94例为观察Ⅰ组，病理诊断为恶性患者59例为观察Ⅱ组。选取我院同期健康体检人员70例为对照组。所有人员均行AFP、CEA、CA199检测，比较单项检测与联合检测的应用价值。结果观察Ⅱ组AFP、CEA、CA199均明显高于对照组和观察Ⅰ组，观察Ⅰ组AFP、CEA、CA199均明显高于对照组，肿瘤Ⅱ、Ⅲ期患者AFP、CEA、CA199均明显高于肿瘤Ⅰ期患者，癌细胞转移患者AFP、CEA、CA199均明显高于未转移患者，特异性由高到低依次为AFP、CEA、CA199、联合诊断，敏感性由高到低依次为联合诊断、AFP、CA199、CEA，准确性由高到低依次为联合诊断、AFP、CEA、CA199，差异均有统计学意义（均P〈0．05）。结论AFP、CEA和CA199联合检测可以显著提高原发性肝癌诊断的准确率，具有较高的敏感度，值得临床推广使用。

Applied research on AFP,CEA and CA199 combined detection in the diagnosis of primary liver cancer

Objective To investigate the clinical value on AFP, CEA and CA199 combined detection in the diagnosis of primary liver cancer. Methods 153 patients with primary liver cancer were selected in our hospital from January 2009 to June 2012 as the observation group. After clinical pathological diagnosis, the patients were divided into two groups： 94 patients were benign as the observation group Ⅰ . 59 patients were malignant as the observation group Ⅱ. 70 health physical examination personnel were selected in our hospital at the same period as the control group. All per- sonnel were detected AFP, CEA, CA199. Clinical value was compared between individual detection and joint detec- tion. Results AFP, CEA, CA199 in the observation group Ⅱ were significantly higher than those in the control group and the observation groupⅠ. AFP, CEA, CA199 in the observation group Ⅰ were significantly higher than those in the control group. AFP, CEA, CA199 of patients with tumor stage Ⅱ,Ⅲwere significantly higher than those of patients with tumor stage Ⅰ . AFP, CEA, CA199 of patients with metastatic cancer cells were significantly higher than those of patients without metastatic tumor. Specificity from high to low was AFP, CEA, CA199, combined detection. Sensitivity from high to low was combined detection, AFP, CA199, CEA. Accuracy from high to low was combined detection, AFP, CEA, CA199. The difference were all statistically significant （all P 〈 0.05）. Conclusion AFP, CEA and CA199 combined detection can significantly improve the diagnosis accuracy of primary liver cancer, which has high sensitivi- ty. That is worthy of clinical use.