血清肿瘤标志物联合检测对原发性肝癌诊断的临床评价

A STUDY OF SIMULTANEOUS DETECTING PRIMARY HEPATIC CANCER BY FIVE TUMOR MARKERS

对１１０例原发性肝癌，１２例肝良占位病变，３２例肝硬化及８３例健康献血员，检测了ＧＳＴ－π（人胎盘谷胱甘肽Ｓ－转移酶），α＿１－ＡＴ（α抗胰蛋白酶），ｓｌｇＡ（血清分泌型免疫球蛋白Ａ），γ－ＧＴ（γ－谷胺酰转移酶），Ｆｅｒｒ（铁蛋白），结果表明各项肿瘤标志物均具有较高的敏感性和一定的特异性。尤其是对ＡＦＰ阴性原发性肝癌的诊断有较明显的价值。本研究表明血清ＧＳＴ－π，ｓＩｇＡ，γ－ＧＴ和ＡＦＰ联合检测对肝癌诊断有特殊的意义，可提高ＡＦＰ阴性肝癌的检出率，并对判别肝良恶性占位性病变有较大的诊断价值。五项指标建立了原发性肝癌线性判别函数，显示出显著的判别效果，正判率为９０．２％，提示联合检测可显著提高原发性肝癌的临床检出率。

his paper is used to evaluate the diagnostic significance of some seroindexes for primaryhepatic cancer(PHC)in clinic,such as human placenta glutathion S-transferase(GST-π),alpha-antitrypsin(α_1-AT),serum secretory IgA(sIgA),γ-glutamyltranspeptidase(γ-GT),ferrititin (Ferr)and alpha fetal protein(AFP).In this study,237 serum samples were de-tected for one or more of seroindexes including 110 primary hepatic cancer,12 liver benign tu-mors and 32 liver cirrhosis as well as 83 normal controls.The results indicated that all of the in-dexes mentioned above were useful to the diagnosis for the PHC,especially in PHC with nega-tive AFP,which the sensitivities for PHC varied from 54.67%to 90.6%。The combined testscould improve the diagnostic sensitivities for PHC. The discriminant function from our studyshowed a satisfactorily discriminant efficiency. The accurately discriminant proportion reachedhighly into 90.2%. The results suggest the simultanously detection of GST-π sIgA,γ-GTmight promote the diagnostic effeciency of PHC with negative AFP and be useful to differentiat-ed the malignant and benign disease of liver.