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不同肿瘤标志物联合检测对PHC诊断的优化模式研究
引用本文:王金桃,闫建文,赵淑芳,韩晓立,张乃珍,高尔生.不同肿瘤标志物联合检测对PHC诊断的优化模式研究[J].现代预防医学,2002,29(3):316-318.
作者姓名:王金桃  闫建文  赵淑芳  韩晓立  张乃珍  高尔生
作者单位:1. 山西医科大学流行病学教研室,030001
2. 山西省肿瘤医院
3. 山西省人民医院
4. 上海市计划生育科学研究所
基金项目:山西省太原市科技启明星资助课题,No:980 8
摘    要:目的:评价不同肿瘤标志物与AFP联合检测对原发性肝癌(PHC)的诊断价值。建立肝癌诊断的优化联检模式。方法:选择目前临床常用诊断肝癌的四种肿瘤标志物(AFP,AFU,FER,GA),在考虑其单独和联合检测对PHC诊断价值的基础上,结合不同权重系数,采用综合权重评分法,对不同联检模式进行等级评分。结果:四项肿瘤标志物的平均水平及阳性率均为肝癌组显著高于对照组(P<0.001),AFP,ASFU,FER,GA的灵敏度分别为75.00%,73.91%,82.80%及84.44%,特异度以AFP最高(97.41%),AFP与其余三项标志物联合检测,其灵敏度均有明显的提高,达94%以上,特异度则以AFP+GA为最高(84.21%),在不同权重系数标准下等级评分,无论从灵敏度,特异度方面,还是从预测值角度分析,均以AFP+GA的综合评分为最高(99分以上),其次为AFP+AFU,本次研究评选出AFP+GA为PHC诊断的最佳模式,结论:AFP为诊断肝癌较特异的肿瘤标志物,甘胆酸作为新的肿瘤标志物,对PHC具有较高的诊断价值。尤其是与AFP联合检测,在诊断的真实性 和效益方面均显示出较好效果,值得在实践中推广应用。

关 键 词:原发性肝癌  肿瘤标志物  联合检测  优化模式
文章编号:1003-8507(2002)03-0316-03
修稿时间:2001年11月5日

STUDY ON THE UNITED DETECTION OPTIMIZATION MODEL OF TUMOR MARKERS FOR PHC
WANG Jin-tao,YAN Jian-wen,ZHAO Shu-fang,et al..STUDY ON THE UNITED DETECTION OPTIMIZATION MODEL OF TUMOR MARKERS FOR PHC[J].Modern Preventive Medicine,2002,29(3):316-318.
Authors:WANG Jin-tao  YAN Jian-wen  ZHAO Shu-fang  
Institution:WANG Jin-tao,YAN Jian-wen,ZHAO Shu-fang,et al.The Department of Epidemiology,Shanxi Medical University Taiyuan,030001.
Abstract:Objective:To evaluate the diadynamic value of united detection of AFP with other tumor markers for primary hepatocellular carcinoma(PHC) and establish the optimization model.Methods:The four tumor markers which are often applied in clinic and include alpha-fetoprotein(AFP),alpha-L-fucosidase(AFU),ferritin(FER) and glycocholic acid(GA) were elected to examine their diagnosing significance for PHC.On the bases of evaluating the diagnosis value of each marker and united marker,the synthetical weight scoring method was used.Results:The average value or positive rate of four tumor markers in PHC group was significantly higher than that in control group( P <0.001).The sensitivity of AFP,AFU,FER and GA was 75.00%,73.91%,82.80% and 84.44%,respectively.The specificity of AFP(97.41%) was the highest among them.The sensitivity was increased with united detection by AFP with either of the other markers(over 94%).The specificity of model AFP+GA was the highest(84.21%).Under A,B,C or D standard with different weight coefficient,either sensitivity,specificity or positive predictive value,negative predicitive value of AFP+GA got the highest score through grade-scoring.Conclusions:AFP has higher specificity for diagnosing PHC.GA was a new tumor marker and had beneficial value.AFP+GA was an optimization model to PHC diagnoses due to their validity and efficiency.
Keywords:Primary hepatocellular carcinoma(PHC)  Tumor markers  United detection  Optimization model
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