若干肿瘤标志物对原发性肝癌诊断的临床评价

目的综合评价血清甲胎蛋白（ＡＦＰ）、α－Ｌ－岩藻糖苷酶（ＡＦｕ）、γ－谷氨酰转肽酶（ＧＧＴ）、唾液酸（ＳＡ）和癌胚抗原（ＣＥＡ）对原发性肝癌（ＰＨＣ）的诊断价值以及联合检测的临床意义。方法对６７例ＰＨＣ、８例肝转移癌、８９例良性肝病及１３１例非肝病者,联合检测ＡＦＰ、ＡＦｕ、ＧＧＴ、ＳＡ和ＣＥＡ。结果５项指标对ＰＨＣ诊断的敏感性分别是６５．４％、７０．８％、３４．８％、６０．２％和３６．４％;特异性分别为９２．６％、９８．１％、８７．１％、９４．５％和７７．８％;ＡＦＰ、ＡＦｕ、ＧＧＴ和ＳＡ联合检测对ＰＨＣ诊断的敏感性是８１．４％,特异性为９１．６％。结论５种肿瘤标记物中,ＡＦｕ和ＡＦＰ对ＰＨＣ诊断意义较大;ＡＦｕ、ＡＦＰ、ＧＧＴ和ＳＡ联合检测可提高对ＰＨＣ诊断的敏感性和特异性。

Clinical evaluation of several tumor markers in the diagnosis of primary hepatic cancer

Objective To evaluate the practical significance of alphafetoprotein(AFP), alpha L fucosidase(AFu), gamma glutamyltransferase(GGT), sialic acid(SA) and carcinoembryonic antigen(CEA) in the diagnosis of primary hepatic cancer(PHC). Methods AFP, AFu, GGT, SA and CEA in the serum were studied in 67 patients with PHC, 8 with hepatic metastasis of gastrointestinal cancer, 89 with benign liver diseases and in 131 controls without liver diseaes. Results According to statistics, the sensitivity of AFP, AFu, GGT, SA and CEA in the diagnosis of PHC was 65.4%, 70.8%, 34.8%, 60.2% and 36.4% repectively; their specificity was 92.6%, 98.1%, 87.1%, 94.5% and 77.8% respectively. CEA in hepatic metastasis of gastrointestinal cancer was higher than that in the other groups of patients. Simultaneous detection of AFP, AFu GGT and CEA gave a diagnostic sensitivity and specificity in PHC of 81.4% and 91.6% respectively. Conclusion AFP and AFu are superior to GGT, SA and CEA in the diagnosis of PHC; simultaneous detection of AFP, AFu, GGT and SA might increase the diagnositic sensitivity and specificity of PHC. CEA was less helpful in the diagnosis of PHC, but might be used to differentiate PHC from hepatic metastasis of gastrointestinal cancer.