多肿瘤标志物蛋白芯片技术在原发性肝癌诊断中的评价

Diagnostic value of multi-tumor marker protein biochip detective system for primary hepatic cancer

目的:探讨多肿瘤标记物蛋白芯片对原发性肝癌的诊断价值。方法:以病理检查或至少1年的临床随访结果为金标准,将2005～2007在我院就诊患者分为原发性肝癌组、良性肝病组和正常对照组,采用蛋白芯片测量技术检测其血清肿瘤标记物。结果:PHC组患者血清CA199、CEA、CA242、FER、AFP、CAl25和CA1537项显著高于健康对照组和良性肝病组(P<0.05)。Lo-gistic回归剔除FER,由其他6项指标诊断PHC的模型为:LogitP=1.357+0.851CA199+1.164CEA+2.573CA242+3.241AFP+2.647CAl25+2.846CA153。6项肿瘤标志物单独检测时,AFP的AUC最大(P<0.05);而6项肿瘤标志物联合检测的AUC要大于各项肿瘤标志物单项检测结果(P<0.05)。结论:应用多肿瘤标志物蛋白芯片技术确定CA199、CEA、CA242、AFP、CAl25和CA1536项的联合检测是筛检原发性肝癌的优化组合,对原发性肝癌的早期诊断有较高临床应用价值。

Objective：To explore the diagnostic value of multi-tumor marker protein biochip detective system for primary hepatic cancer. Methods： Using pathological examination, or at least one-year clinical follow-up results for the gold standard, we divided patients with liver disease into three two groups： primary liver cancer group, benign liver disease group and normal group, using protein chip technology to detect the measurement serum tumor markers. Results：CA199, CEA, CA242, FER, AFP, CA125 and CA153 were significantly higher in PHC group than those in benign liver disease group and normal group （P〈0.05）. Logistic regression excluding FER, from the other six in- dicators for the diagnosis of PHC model： Logit P=1.357 ＋0.851 CA199 ＋1.164 CEA ＋2.573 CA242 ＋3.241 AFP ＋2.647 CA125 ＋2.846 CA153. Six tumor markers detected separately, the AUC of AFP is the largest （P〈0.05）;Combined measure of six tumor markers has greater AUC than the single tumor marker test （P〈0.05）. Conclusion： Combined CA 199, CEA, CA242, AFP, CA125 and CA 153 is the optimum combination for early diagnosis of primary liver cancer, it has a high clinical value.