血清AFP、CEA、AFU、GGT-Ⅱ联合检测诊断原发性肝癌的临床价值

目的探讨血清甲胎蛋白、癌胚抗原、α-L-岩藻糖苷酶、γ-谷氨酰转肽酶同工酶Ⅱ联合检测在原发性肝癌诊断中的应用价值。方法采用ELISA法检测160例原发性肝癌患者及120例健康体检者血清中的甲胎蛋白、癌胚抗原、α-L-岩藻糖苷酶含量,同期采用不连续梯度聚丙烯酰胺凝胶电泳法测定上述对象的血清γ-谷氨酰转肽酶同工酶Ⅱ,使用SPSS 15.0软件包进行数据处理。结果原发性肝癌组血清甲胎蛋白、癌胚抗原、α-L-岩藻糖苷酶含量与健康对照组比较,差异均有高度统计学意义（均P〈0.01）;血清甲胎蛋白、癌胚抗原、α-L-岩藻糖苷酶、γ-谷氨酰转肽酶同工酶Ⅱ各自单项检测的阳性率分别为68.00%、28.00%、84.00%、77.00%,其中癌胚抗原及α-L-岩藻糖苷酶及γ-谷氨酰转肽酶同工酶Ⅱ的阳性率均明显升高,与健康对照组比较,差异均有统计学意义（均P〈0.05）;此外血清甲胎蛋白联合癌胚抗原或甲胎蛋白联合α-L-岩藻糖苷酶或甲胎蛋白联合γ-谷氨酰转肽酶同工酶Ⅱ检测的阳性率分别为75.00%、84.00%、89.00%,甲胎蛋白、α-L-岩藻糖苷酶联合检测及甲胎蛋白、γ-谷氨酰转肽酶同工酶Ⅱ联合检测与甲胎蛋白单项检测相比差异均有统计学意义（均P〈0.05）;此外血清甲胎蛋白同时联合癌胚抗原、α-L-岩藻糖苷酶、γ-谷氨酰转肽酶同工酶Ⅱ4项检测原发性肝癌的检出阳性率为96.00%,明显高于甲胎蛋白单项检测的检出阳性率,两者相比差异有高度统计学意义（P〈0.01）。结论使用血清甲胎蛋白、癌胚抗原、α-L-岩藻糖苷酶、γ-谷氨酰转肽酶同工酶Ⅱ联合检测有助于原发性肝癌的早期诊断,值得在临床工作中推广应用。

Clinical value of combined measurement of serum alpha-fetoprotein,carcinoembryonic antigen,alpha-L-fucosidase,gamma-glutamyltransferase isoenzymes for diagnosis of primary liver cancer

Objective To evaluate the clinical value of combined measurement of four serum tumor markers（alpha-fetoprotein,carcinoembryonic antigen,alpha-L-fucosidase,gamma-glutamyltransferase isoenzymes） for diagnosis of primary liver cancer.Methods 160 patients with primary liver cancer and 120 healthy subjects were measured the serum levels of alpha-fetoprotein,carcinoembryonic antigen,alpha-L-fucosidase,gamma-glutamyltransferase isoenzymes was detected by using not continuous PAGE.The results were analyzed by SPSS 15.0 software.Results The serum levels of alpha-fetoprotein,carcinoembryonic antigen,alpha-L-fucosidase were significantly higher in the primary liver cancer patients than those in the control group（P 0.01）.The positive rate of single marker of alpha-fetoprotein,carcinoembryonic antigen,alpha-L-fucosidase,gamma-glutamyltransferase isoenzymes was 68.00%,28.00%,84.00% and 77.00% respectively,and there were statistical significances during carcinoembryonic antigen,alpha-L-fucosidase,gamma-glutamyltransferase isoenzymes（all P 0.05）.The positive rate of the combined measured of two markers： alpha-fetoprotein/carcinoembryonic antigen,alpha-fetoprotein/alpha-L-fucosidase and alpha-fetoprotein/gamma-glutamyltransferase isoenzymes were 75.00%,84.00% and 89.00% respectively,and there were statistical significances during the positive rates of the combined measured of alpha-fetoprotein/alpha-L-fucosidase,alpha-fetoprotein/gamma-glutamyltransferase isoenzymes compared with alpha-fetoprotein（all P 0.05）.But the positive rate of combined measurement of four markers was 96.00% and there was evidently statistical significance compared with the alpha-fetoprotein result（P 0.01）.Conclusion The combined measurement of alpha-fetoprotein,carcinoembryonic antigen,alpha-L-fucosidase,gamma-glutamyltransferase isoenzymes can be used as an accessory tool in diagnosis of primary liver cancer.