多种血清肿瘤标记物联合检测在原发性肝癌临床诊断中的价值

目的:探讨血清中甲胎蛋白（alpha fetoprotein，AFP）、α-L-岩藻糖苷酶（α-L-fucosidase，AFU）、癌胚抗原（carcinoembryonic antigen，CEA）、癌抗原199（cancer antigen 199，CA199）的联合检测在原发性肝癌临床诊断中的价值。方法:选取97例原发性肝癌患者作为肝癌组，同期收治的65例肝良性疾病患者作为良性组，50例体检健康者作为健康组，采用电化学发光法对三组受检者血清中的AFP、AFU、CEA、CA199的水平进行检测，并比较三组血清肿瘤标记物的检测结果，血清肿瘤标记物单独检测和联合检测的敏感性与准确性。结果:肝癌组血清中AFP、AFU、CEA、CA199的水平显著高于良性组和健康组，差异有统计学意义（P＜0.05）。与高分化和中分化的原发性肝癌患者相比，未分化和低分化患者血清肿瘤标记物水平显著提高，差异有统计学意义（P＜0.05）；与未发生肿瘤转移组相比，出现原发性肝癌转移组的血清标记物水平明显升高，差异有统计学意义（P＜0.05）；HBV感染组与HBV未感染组的血清肿瘤标记物水平比较，差异无统计学意义（P＞0.05）。四项血清肿瘤标记物联合检测诊断原发性肝癌的敏感性达90.72%，准确性达87.65%，与单项肿瘤标记物检测相比，差异有统计学意义（P＜0.05）。结论:血清中上述四项肿瘤标记物的检测均可作为原发性肝癌诊断的指标，四项肿瘤标记物联合检测有助于提高原发性肝癌诊断的敏感性和准确性。

The value of combined detection of serum tumor markers in the diagnosis of primary liver cancer

Objective:To investigate the value of combined detection of serum tumor markers alpha fetoprotein (AFP),α-L-fucosidase (AFU),carcinoembryonic antigen (CEA) and cancer antigen 199 (CA199) in the diagnosis of primary liver cancer.Methods:97 patients with primary liver cancer were selected as liver cancer group,another 65 patients with liver benign lesions were selected as benign group.50 healthy volunteers were selected as healthy group.The serum concentration of AFP,AFU,CEA and CA199 was determined by electrochemiluminescence immunoassay in the three groups.Those results were compared to analyze the diagnostic value of these tumor markers.Results:The serum levels of four tumor markers in the liver cancer group were significantly higher than those in the benign group and the healthy group (P＜0.05).The serum levels of tumor markers in poor differentiation group and undifferentiated group were significantly higher than those in well and moderate differentiation group in primary liver group (P＜0.05).Compared with the non-metastatic group,the levels of serum markers in the group with metastasis of primary liver cancer were remarkly higher (P＜0.05).There was no significant difference in serum tumor markers between HBV infection group and non-HBV infection group （P＞0.05）.By the combined detection of the four tumor markers in liver cancer group,the sensitivity and accuracy were 90.72% and 87.65% respectively,which significantly higher than those of a single marker.Conclusion:The tumor markers AFP,AFU,CEA and CA199 in the serum may be the indicators in diagnosis of primary liver cancer.The combined detection of serum tumor markers would significantly improve the sensitivity and accuracy in diagnosis of primary liver cancer.