联合检测4种肿瘤标志物对诊断原发性肝癌的意义

目的：探讨血清甲胎蛋白（A FP ）、甲胎蛋白异质体3（A FP‐L3）、铁蛋白（FER ）和α‐L‐岩藻糖苷酶（AFU ）的联合检测在原发性肝癌（PHC）中的诊断价值。方法选取鼓楼医院2012年1月至2013年12月住院患者200例，包括良性肝病患者87例和PHC患者113例，并选择同期健康体检者80例为健康对照组，对其 AFP、AFP‐L3水平进行检测，同时检测标本中FER和 AFU 的水平，判断其之间的关系。结果 PHC患者AFP、AFP‐L3、FER和AFU水平明显高于良性肝病组和健康对照组，差异有统计学意义（P＜0．05）。经 ROC曲线分析，AFP 405．4 ng／mL、AFP‐L336．6 ng／mL、FER 321．6 ng／mL和AFU 40．2 U／L联合应用的临界值，敏感度可达84％，特异度可达82％，均高于单项指标诊断。结论联合检测血清AFP、AFP‐L3、FER和AFU 在诊断PHC中有重要价值，可提高临床诊断准确性。

Value of combined detection of four tumor markers in the diagnosis of primary hepatic cancer

Objective To explore the value of combined detection of α‐fetoprotein （AFP） ,AFP heteroplasmon 3 （AFP‐L3 ） ,ferritin （FER ） and α‐L‐fucosidase （AFU ） in the diagnosis of primary hepatic cancer （PHC ） . Methods During Jan .2012 and Dec .2013 ,the levels of AFP ,AFP‐L3 ,FER and AFU were detected and compared a‐mong 87 cases with benign liver diseases （benign liver diseases group） ,113 cases with PHC ,and 80 healthy subjects （control group） .Then ,the diagnostic performance was analyzed .Results The levels of AFP ,AFP‐L3 ,FER and AFU were significantly increased in patients with PHC ,compared with benign liver diseases group and control group （P〈0 .05） .Analysis of receiver operating characteristic （ROC） curve indicated that the diagnostic sensitivity and specific‐ity of combined detection of AFP ,AFP‐L3 ,FER and AFU were 84% and 82% ,which were higher than single detec‐tion of these four parameters ,when taking the cut‐off values of 405 .4 ng/mL ,36 .6 ng/mL ,321 .6 ng/mL and 40 .2 U/L for each marker respectively .Conclusion Combined detection of AFP ,AFP‐L3 ,FER and AFU might be with important value for the diagnosis of PHC .