联合检测CA199、CEA、β_2-MG在原发性肝癌中的临床价值

Diagnostic value of combined determination of serum CA199, CEA and β_2-MG levels in patients with primary hepatic carcinoma

目的联合检测CA199、CEA、β2-MG3项肿瘤标志物以探讨其对肝脏疾病癌变的诊断价值。方法采用电化学发光免疫法及放射免疫法对肝癌组46例、肝硬化组30例、肝炎组37例及正常对照组40例患者的CA199、CEA和β2-MG进行联合检测。结果3项指标浓度水平在原发性肝癌组高于肝硬化组,肝硬化组高于肝炎组,其差异均有显著性(P<0.05),肝炎组与正常对照组比较,差异无显著性(P>0.05)。此外,3项指标联合检测阳性率与2项或单项指标比较在原发性肝癌差异有显著性(P<0.01),而在转移性肝癌差异无显著性(P>0.05)。结论应用CA199、CEA、β2-MG3项指标联合检测能提高原发性肝癌的阳性检出率(可达85%以上)。

[Objective] To investigate the diagnostic value of combined detection of three tumor markers CA199, CEA and β2-MG in patients with possible malignant change in liver disorders. [Methods] Serum CA199, CEA and β2-MG levels were determined with eleetroehemilumineseenee immunoassay （ECLIA） and radioimmunoassay （RIA） in 39 patients with primary liver carcinoma, 7 patients with metastatic liver ianeareinoma, 30 patients with hepatic cirrhosis, 37 patients with HBV hepatitis and 40 controls. [Results] The serum levels of CA199, CEA, β2-MG in patients with primary hepatic cancer and hepatic cirrhosis were all significantly higher than those in controls （P 〈 0.05）. The serum levels of the three markers in patients with primary hepatic cancer were significantly higher than those in hepatic cirrhosis （P 〈0.05）. However, serum levels of the three markers in patients with hepatitis were not much different from those in eontrols （P 〉0.05）. Moreover, positive rate of combined determination of CA199, CEA, β2-MG was significantly higher than that of CEA or CEA, CA199 in patients with primary hepatic cancer （P 〈0.01 ）. However, positive rate of the three markers was not much different in patients with metastatic liver eaneer（P 〉0.05）. [Conclusions] With combined determination of CA199, CEA and β2-MG the detection rate of primary hepatic eareinoma could be enhanced to above 85%.