血清甲胎蛋白、糖链抗原125、糖链抗原199和癌胚抗原检测在肝脏疾病诊断中的应用

The application of alpha-fetoprotein,carbohydrate antigen-125,carbohydrate antigen-199 and carcinoembryonic antigen in hpatopathy

目的探讨血清甲胎蛋白(AFP)以及AFP联合糖链抗原125(CA125)、糖链抗原199(CA199)和癌胚抗原(CEA)在肝脏疾病中的鉴别诊断作用。方法随机选择2000例肝脏疾病患者(肝脏疾病组)和51例健康体检者(健康对照组),采用瑞士罗氏E170电化学发光分析仪检测血清AFP、CA199、CA125和CEA。并研究分别探讨AFP单独、AFP分别与CEA、CA125、CA199联合以及4种标志物联合应用在不同肝脏疾病诊断的敏感性、特异性和准确率。结果肝脏疾病组中,肝癌734例(36.70%),为肝癌亚组;良性肝病1266例(63.30%),为良性肝病亚组。肝癌亚组血清含量AFP、CA199、CA125、CEA与良性肝病亚组及对照组比较差异均有统计学意义(P<0.05),良性肝病亚组各项与对照组比较差异亦有统计学意义(P<0.05)。单独AFP检测特异性为92.41%高于其他检测特异性,差异有统计学意义(P<0.05);4项指标联合诊断敏感性最高达98.39%,与其他检验项目敏感性比较,差异有统计学意义(P<0.05)。结论 AFP联合多种肿瘤标志物可提高对肝病的鉴别诊断准确性,减少漏诊。

Objective To discuss the role of differential diagnosis of alpha-fetoprotein（AFP） and AFP combined carbohydrate antigen-125（CA125）,carbohydrate antigen-199（CA199） and carcinoembryonic antigen（CEA） in hpatopathy.Methods Randomly selected 2000 cases patients with hpatopathy（hpatopathy group） and 51 cases healthy peoples（control group）,with Roche E170 electrochemiluminescence analyzed serum AFP,CA199,CA125 and CEA.And investigated AFP,AFP separately with CEA,CA125,CA199 joint,and four kinds of markers used in the diagnosis of hpatopathy of different sensitivity,specificity and accuracy.Results Hpatopathy group,734 cases of liver cancer（36.70% ）,was as liver cancer subgroup;1266 cases of benign liver diseases（63.30% ）,was as benign liver disease subgroups.Content of serum AFP,CA199,CA125,CEA of liver cancer subgroup compared with benign liver disease subgroup and control group,the differences were statistically significant（P 0.05）,those levels of benign liver disease subgroup compared to control group,there had statistically significant differences（P 0.05） .Separate AFP test specificity（92.41% ） higher than that of other test-specific,the difference was statistically significant（P 0.05）;4 indicators combined diagnostic sensitivity of up to 98.39%,compared with the sensitivity of other test items,there was significant difference（P 0.05） .Conclusion AFP combined tumor markers can improve the accuracy of the differential diagnosis of liver disease and reduce misdiagnosis.