组织多肽特异性抗原在原发性肝癌中的临床应用

Clinical value of serum tissue polypeptide specific antigen detection for primary hepatic cancer

目的探讨组织多肽特异性抗原(TPS)对原发性肝癌的临床应用价值,并与甲胎蛋白(AFP)进行比较。方法采用酶联免疫吸附法,分别测定85例原发性肝癌、19例肝转移癌、35例肝硬化、22例慢性肝炎和50例健康查体者血清TPS和AFP水平,并应用ROC曲线分析其对肝癌的诊断价值。结果AFP对原发性肝癌的诊断价值高于TPS。肝细胞癌组AFP血清水平高于胆管癌组(P=0.037),但两组之间TPS血清水平无显著性差异(P=0.737)。TPS与肿瘤大小之间存在显著相关性(P=0.001),但与肿瘤数目、门脉癌栓、肝外转移、临床分期及病理分级均无显著相关性(P>0.05);AFP与肿瘤大小、门脉癌栓及病理分级之间存在显著相关性(P<0.05=)。结论单独检测TPS的血清水平对原发性肝癌未显示出比AFP更高的诊断价值,但对胆管癌的诊断具有一定的指导意义。血清TPS对原发性肝癌与肝转移癌、肝硬化及肝炎的鉴别能力较差,限制了其临床应用价值。

Objective To evaluate the clinical value of serum tissue polypeptide specific antigen (TPS) for primary hepatic cancer in comparison with alpha-fetoprotein (AFP). Methods TPS and AFP were measured by enzyme-linked immunosorbent assay (ELISA) in 85 patients with primary hepatic cancer, 19 with metastatic hepatic cancer, 35 with liver cirrhosis, 22 with chronic hepatitis and 50 healthy control subjects. Results Serum AFP levels were elevated in patients with hepatocellular carcinoma in comparison with that in cholangiocarcinoma patients (P=0.037), but the difference was not significant (P=0.737). Serum TPS levels were significantly correlated with the tumor size (P=0.001), but not with the number of the tumors, portal invasion, extrahepatic metastasis, clinical stage or histological differentiation (P>0.05). A significant correlation was observed between AFP level and tumor size (P=0.028), portal invasion(P=0.005), and histological differentiation (P=0.000). Conclusion TPS alone offers no more clues than AFP for the diagnosis of primary hepatic cancer, though it can be helpful for the diagnosis of cholangiocarcinoma. It has only limited clinical utility as a marker for primary hepatic cancer.