联检肝癌标志物对高危人群早期肝癌筛查的临床价值

Clinical value of combining different tumor markers in detecting early primary liver cancer in high-risk groups

目的探讨联合检测肝癌标志物对肝癌高危人群早期肝癌的诊断价值。方法从住院及体检中抽取1 000例HBsAg阳性的乙型肝炎患者,随机分为联检组(300例)和对照组(700例)。联检组每半年检测1次血清AFP、AFU、GGT-Ⅱ、TSGF,阳性患者追加检测次数同时进行影像学检查;对照组则不定期检测上述肝癌标志物和定期电话随访。结果联检组5年共检出早期肝癌4例,均为小肝癌。对照组5年发现肝癌8例,无1例早期肝癌病例。结论应用AFP、APU、GGT-Ⅱ、TSGF肿瘤标志物联合检测可明显提高肝癌的早期诊断,尤其对高危人群意义更大。

Objective To investigate the significance of the combined detection with different tumor markers for early screening primary liver cancer in the high-risk groups. Methods One thousand patients with positive HBsAg were enrolled from in-patients and physical examination patients, and randomly divided into two groups： the group of combined tests （n = 300） and control group （n = 700）. AFP combined with AFU, GGT- Ⅱ and TSGF tests were offered to combined test group every 6 months. Patients with AFP, AFU, GGT-Ⅱ and TSGF positive were followed by imaging check; controls were detected all above of tumor markers in unfixed intervals and followed up by telephone. Results Four patients at early stage of primary liver cancer were observed in group of combined tests for 5 years, and all were small hepatocellular carcinoma ; eight cases were detected in the control group and no one case was at early stage of primary liver cancer. Conclusion The early diagnostic accuracy of primary liver cancer can be improved by combined tests of AFP, AFU, GGT and TSGF.