血清甲胎蛋白、肿瘤相关物质和癌胚抗原对原发性肝癌的鉴别诊断

Differential diagnosis of primary hepatic carcinoma by detecting serum alpha-fetoprotein,tumor-associated substances and carcinoembryonic antigen

目的:探讨甲胎蛋白(AFP)、肿瘤相关物质(TSGF)、癌胚抗原(CEA)联合检测对原发性肝癌(PHC)的互补诊断价值及疗效观察的价值.方法:收集PHC患者100例(PHC组)、良性肝病患者100例(良性肝病组)及健康体检者100例(对照组)的血清样品.用电化学发光免疫测定法和生物化学比色定量法检测AFP、TSGF和CEA含量,并进行比较.结果:PHC治疗组的AFP+TSGF+CEA联合检测阳性率为95%,高于单纯AFP检测阳性率(70%)、TSGF检测阳性率(61%)和CEA检测阳性率(57%),联合检测阳性率与单项指标检测PHC阳性率相比较,差异有统计学意义(P<0.05);AFP+TSGF+CEA联合检测灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于单项肿瘤标志物的检测结果,与单项肿瘤标志物检测结果相比较,差异有统计学意义(P<0.05);治疗后,PHC患者AFP、TSGF、CEA血清水平明显降低,与治疗前相比较,差异有显著统计学意义(P<0.01).结论:联合检测AFP、TSGF和CEA三项指标,可提高PHC尤其是AFP阴性的PHC诊断率,对肝肿瘤的良恶性辅助诊断及鉴别诊断具有一定应用价值.

AIM：To investigate the value of combined detection of serum alpha-fetoprotein （AFP）, tumor-associated substances （TSGF） and carcinoembryonic antigen （CEA） in the diagnosis of primary hepatic carcinoma （PHC）.METHODS：Serum samples from 100 patients with primary hepatic carcinoma （PHC group）, 100 patients with benign liver disease （benign liver disease group） and 100 healthy individuals （control group） were used to detect the contents of AFP, TSGF and CEA by electrochemical lumi-nescence immunoassay and biochemical colorimetric assay.RESULTS：In the PHC group, the positive rate of combined detection of AFP, TSGF and CEA was 95%, significantly higher than those of detection of AFP （70%）, TSGF （61%） or CEA （57%） alone （all P0.05）.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the combined detection method were significantly higher than those of detection of a single tumor marker （all P0.05）.After treatment, serum levels of AFP, TSGF and CEA signifi cantly declined in PHC patients when compared with pre-treatment values （all P0.01）.CONCLUSION：Combined detection of AFP, TSGF and CEA can not only improve the diagnosis of PHC, especially in AFP-negative patients, but also help make a differential diagnosis between benign and malignant liver tumors.