血清AFP、CEA、CA125、CA199在原发性肝癌诊断中的应用价值

目的：探讨AFP（甲胎蛋白）、CEA（癌胚抗原）、CA125（糖链抗原CA125）、CA199（糖链抗原CA199）等四种肿瘤标志物在原发性肝癌（primaryhepaticcancer，PHC）辅助诊断中的应用价值，为临床应用中选择优化合理、经济实用的肿瘤标志物组合提供参考依据。方法：以化学发光标记免疫法测定原发性肝癌组40例、肝脏良性疾病组55例、正常对照组52例中AFP、CEA、CA125、CA199的含量，比较四种肿瘤标志物单独或联合检9n,4对原发性肝癌诊断的敏感性和准确性。结果：PHC组中血清AFP、CEA、CA125、CA199含量显著高于良性肝病组及正常对照组（P〈0．05）。4种肿瘤标志物的联检阳性率为85．0％，显著高于良性肝病组（40．0％）和正常对照组（5．7％）（P均〈0．01）；联合检测在提高PHC诊断敏感性（P〈0．05）的同时，特异性有所下降（P〈0．05）。结论：肿瘤标志物AFP、CEA、CA125、CA199联合检测可提高诊断PHC的阳性诊断率，四种肿瘤标志物联检对PHC有十分重要的诊断价值。

Value of AFP,CEA,CA125,CA199 level in primary hepatic cancer diagnosis

Objective:To explore the value of four tumor markers including AFP(alpha fetoprotein),CEA,CA125,and CA199 in the diagnosis of primary hepatic cancer in order to find evidence for choosing optimized detection of tumor markers.Methods:Chemiluminescence immunoassay method was applied to detecte the AFP,CEA,CA125,CA199 levels in 40 cases of primary liver cancer,55 cases of benign liver disease,and 52 normal controls in order to investigate the sensitivity and accuracy of the four tumor markers(alone or combined detected)in the diagnosis of primary liver cancer.Results:Serum AFP,CEA,CA125 and CA199 levels of primary liver cancer cases were significant higher than that of the benign liver disease cases and normal controls(P<0.05).Joint detection of the four tumor markers showed a positive rate of 85.0% in primary liver cancer cases,significant higher than that in benign liver disease cases(40.0%)and normal controls(5.7%)(P all <0.01).Joint detection of the four tumor markers improved the diagnostic sensitivity(P< 0.05),while decreased the specificity at the same time(P <0.05).Conclusion:Joint detection of four tumor markers including AFP,CEA,CA125 and CA199 can improve diagnosis accuracy of primary liver cancer with significant diagnostic value.