肝功能生化指标对常用肿瘤标志物检测的影响

Influence of liver function on the detection of common tumor markers

目的:探讨肝脏代谢对常用肿瘤标志物检测结果的影响.方法:回顾我院2004-01/2005-03收治入院诊断明确且具有完整肿瘤标志物(AFP、CEA和CA19-9)和肝功能各生化指标患者845例,分为普通疾病组、良性肝胆胰疾病组和恶性肿瘤组,对不同组别的肿瘤标志物与肝功能生化指标进行分析.结果:恶性肿瘤和普通疾病组中肝功能异常者的AFP高于肝功能正常者(z=-3.917,2.252;P<0.01或0.05).在普通疾病组中AFP与TBIL、DBIL、γ-GT存在正相关(r=0.082,0.133,0.190;P<0.01或0.05).在三组不同疾病组中肝功能正常与异常者的CEA未发现有差异.普通疾病组中CEA与γ-GT、ALP存在正相关性(r=0.171,0.139;均P<0.01).恶性肿瘤组中肝功能异常者的CA19-9高于正常者(z=-1.973,P<0.05).三组不同疾病中CA19-9与多种肝功能指标存在正相关.结论:胆道梗阻对CA19-9测定值有明显影响;低水平AFP与γ-GT有一定关系;而CEA则与肝功能无明确关系.

AIM： To investigate the influence of liver metabolism on the detection of common tumor markers. METHODS： A total of 845 patients admitted from January 2004 to March 2005 were divided into 3 groups： common disease group （A）, benign hepatobiliary and pancreatic disease group （B） and malignant tumor group （C）. The correlation between liver function and tumor markers were analyzed retrospectively in the three groups. RESULTS： The level of alphaetoprotein （AFP） was significantly higher in group A and B than that in group C （z = -3.917, 2.252; P 〈 0.01 or 0.05）. AFP level had positive correlations with total bilirubin, direct bilirubin and γ-glutamyl transferase （γ-GT） in patients with common diseases （r = 0.082, 0.133, 0.190; P 〈 0.01 or 0.05）. The level of carcinoembryonic antigen （CEA） was not markedly different between patients with normal liver function and abnormal liver function, and was found positively correlated with γ-GT and alkaline phosphatase （ALP） levels in patients with common disease （r = 0.171, 0.139; both P 〈 0.01）. In group C, the level of carbohydrate antigen 19-9 （CA19-9） was higher in patients with abnormal liver function than that in those with normal liver function （z = -1.973, P 〈 0.05）. Positive correlations were found between CA19-9 level and liver function indexes in the three groups. CONCLUSION： Obstruction of bile duct may affect CA19-9 detection, and low AFP level correlates with γ-GT; however, hepatic metabolism may not influence CEA detection.