肿瘤标志物联合检测对原发性肝癌的诊断价值

Diagnostic value of combined detection of serum tumor marker in primary hepatic carcinoma

目的:探讨7种血清肿瘤标志物(TM)对肝癌的诊断价值,并筛选出对原发性肝癌(PHC)有价值的TM组合。方法:采用免疫化学发光法测定甲胎蛋白(AFP)、糖链抗原199(CA19-9)、糖链抗原125(CA125)、癌胚抗原(CEA)水平;用连续监测法测定α-L-岩藻糖苷酶(AFU)、r-谷氨酰转移酶(r-GT)、碱性磷酸酶(AKP)。共检测了78例PHC患者和92例肝硬化患者、75例肝炎组及58例健康成人。结果:平行试验敏感性达100%和系列试验特异性达99%的组合有AFP+CA125+r-GT、AFP+AKP+r-GT、AFP+AKP+r-GT+CA199、AFP+CA199+r-GT;总阳性似然比高的组合有AFP+CA125+AKP、AFP+CA199+AKP、AFP+AKP+r-GT。结论:对PHC患者合理的组合为AFP+CA125+AKP、AFP+CA199+AKP、AFP+AKP+r-GT。

Objective：To investigate the value of combined detection of 7 serum tumor markers（TM） in the diagnoisis of primary hepatic carcinoma（PHC）,and screening valuable panel of serum tumor markers（TM）for primary hepatic carcinoma.Methods： Using immune Chemiluminescence determination of α-fetoprotein（AFP）,carbohydrate antigen 199（CA19-9）,carbohydrate antigen 125（CA125）,carcinoembryonic antigen（CEA） level;determined by continuous monitoring of α-L-fucosidase（AFU）,r-glutamyl transferase（r-GT）,alkaline phosphatase（AKP）.A total of 78 cases of PHC and 92 patients with liver cirrhosis,75 cases of hepatitis,58 healthy adults were examined.Results： 100% sensitivity in parallel test and 99% specificity in serial test were found in panel of AFP ＋ CA125＋ r-GT,AFP ＋ AKP ＋ r-GT,AFP ＋ AKP ＋ r-GT ＋ CA199,AFP ＋ CA199 ＋ r-GT;The positive likelihood ratio of AFP ＋ CA125 ＋ AKP,AFP ＋ CA199 ＋ AKP,AFP ＋ AKP ＋ r-GT were higher among all the panel.Conclusion： The reasonable combination of TM for the PHC were AFP ＋ CA125＋ AKP,AFP ＋ CA199 ＋ AKP,AFP ＋ AKP ＋ r-GT.