肝病患者甲胎蛋白和癌胚抗原肿瘤标志物检测分析

Analysis to combine detection of alpha fetoprotein and carcinoembryonic antigen in patients with hepatopathy.

目的探讨联合检测甲胎蛋白(AFP)和癌胚抗原(CEA)对原发性肝癌、转移性肝癌、肝硬化和病毒性肝炎的鉴别诊断价值。方法对83例原发性肝癌,29例转移性肝癌,46例肝硬化,71例病毒性肝炎和60例健康对照者,用微粒子化学发光免疫分析法测定血清AFP和CEA。结果原发性肝癌AFP极度增高,达(3542.3±5647.4)μg/L,肝硬化组AFP中度增高,为(115.3±218.4)μg/L,病毒性肝炎组和转移性肝癌组AFP均轻度增高,分别为(36.4±52.6)μg/L和(26.9±79.4)μg/L;肝病患者以AFP>400μg/L作为界值诊断原发性肝癌的灵敏度为73.49%,特异性达99.32%。CEA以转移性肝癌组最高,为(75.6±162.1)μg/L,明显比原发性肝癌、肝硬化、病毒性肝炎和健康对照组高(F=10.97,P<0.01)。结论联合检测AFP和CEA对原发性肝癌、转移性肝癌、肝硬化和病毒性肝炎有较好的鉴别诊断价值。

Objective To study the diagnostic value of combined detection of alpha fetoprotein（AFP）and carcinoembryonic antigen（CEA）on distinguishing primary hepatic carcinoma（PHC）,metastatic hepatic carcinoma（MHC）,cirrhosis and viral hepatitis.Methods AFP and CEA were measured in 83 patients with PHC,29 patients with MHC,46 patients with cirrhosis,71 patients with viral hepatitis and in 60 healthy subjects by microparticle chemiluminescent immunoassay,respectively.Results The study revealed that patients with PHC had improved greatly to a higher level of AFP（3542.3±5647.4μg/L）,while concentration of AFP in cirrhosis group was a moderate elevated（115.3±218.4μg/v）and both in viral hepatitis group and MHC group was slight elevated（36.4±52.6μg/L,26.9±79.4μg/L,respectively）.As a threshold value of AFP greater than 400 μg/L to diagnose PHC,it was 73.49% for sensitivity and 99.32% for specificity,respectively.The group of patients with MHC had significantly higher level of CEA（75.6±162.1μg/L）compared to that with PHC,cirrhosis,viral hepatitis groups and controls（analysis of variance,P〈0.01）.Conclusion There is a use of diagnostic value on distinguishing PHC,MHC,cirrhosis and viral hepatitis by combined determination of AFP and CEA.