转化生长因子β_1联合检测对原发性肝癌的诊断价值

CLINICAL EVALUATION OF COMBINED SERUM TUMOR MARKERS:TGFβ_1,SAIF,γ-GTⅡAND DCP IN THE DIAGNOSIS OF PRIMARY HEPATIC CARCINOMA

目的:探讨转化生长因子β_1(TGFβ_1)、血清酸性同功铁蛋白(SAIF)、异常凝血酶原(DCP)、γ-谷氨酰转肽酶同功酶γ-GTⅡ等肝癌标志物联合检测对原发性肝癌(PHC)的诊断价值。方法:选择43例 PHC(22例组织学证实)和77例其他肝病及消化道恶性肿瘤患者进行肝癌标志物的同步测定。结果:PHC 的TGFβ_1、SAW、DCP、γ-GTⅡ较正常对照组显著增高(P 值<0.01),PHC 组各项标志物的敏感性依次为γ-GTⅡ(81.%%)>SAIF(74.4%)>TGFβ_1(72.3%)>DCP(62.8%),特异性依次为γ-GTⅡ和 DCP(89.6%)>SAIF(81.8%)>TGFβ_1(77.9%),结合 AFP 联合检测的阳性率达95.5%。同时可将 AFP 阴性 PHC 及小肝癌的诊断阳性率提高到85.7%。结论:肝癌标志物联合检测对诊断 PHC 有重要价值,尤其是 AFP 阴性 PHC及小肝癌的诊断阳性率得到提高。

Objective:In order to evaluate combined serum tumor markers in the diagnosis of primary hepatic carcinoma (PHC),four tumor markers were determined.Methods:Transforming growth factor β1(TGF β1),gamma-glutamyl transpeptidase isozyme(γ-GTⅡ),serum acidic isoferritin (SAIF) and des-γ- carboxy prothrombin (DCP) were concomitantly determined in 43 patients with PHC and 77 patients with various liver diseases and gastrointestinal tumors.Results:TGFβ1,γ-GTⅡ,SAIF,DCP levels were in- creased significantly in PHC(P<0.01);the diagnostic sensitivity of these markers in PHC were γ-GTⅡ (81.4%)>SAIF(74.4%)>TGFβ1(72.3%)>DCP(62.8%),and specifcity were γ-GTⅡ and DCP(89.6%)> SAIF(81.2%)>TGFβ1(77.9%),respectively;no correlation could be found among these four tumor markers. The diagnostic positivity of combined assays was 85.7% in PHC with low or negative AFP,while 95.5% in those with elevated AFP;in 7 small PHC patients,the diagnostic positivity of combined assays was 71.4%, while 85.7% in those with elevated AFP.Conclusion:Our data suggest that the combined assay of serum tumor markers is valuable in the diagnosis of PHC,especially in low or negative AFP patients.