5种血清肿瘤标志物联合检测在肝癌诊断中的应用研究

Evaluation of five kinds of serum tumor markers combination detection in the diagnosis of hepatoma

目的探讨5种血清肿瘤标志物(TM)联合检测对肝癌诊断的应用价值。方法选择150例肝癌患者为研究组,50例肝炎和50例肝硬化患者为良性肝病组及50例健康人为对照组,各组同步检测AFP、CEA、CA199(采用ELISA法),AFU、TSGF(用生化定量分析法)。结果肝癌组的5种TM血清检测水平较良性肝病组和对照组均有明显升高,差异均有显著性(P<0.05)。150例肝癌组中,单项指标的阳性率由高到低依次为AFU(74.67%)>AFP(61.33%)>TSGF(53.33%)>CEA(12.00%)>CA199(11.33%),5项指标联合检测,阳性率可提高到97.33%;在58例AFP阴性肝癌患者中,AFU、TSGF、CEA、CA199的阳性率分别为63.79%、65.52%、27.59%、22.41%,4项指标联合检测阳性率可达到93.10%,与各单项阳性率比较,差异均非常显著(P<0.01)。结论 5种TM联合检测能显著提高肝癌的阳性检出率,具有很好的互补诊断和临床应用价值。

【Objective】 To evaluate the clinical diagnosis value of five kinds of serum tumor markers combination detection in hepatoma.【Methods】 Serum AFP,CEA,CA199 levels were determined with ELISA and AFU,TSGF levels were determined with biochemistry in 150 patients with liver carcinoma,50 patients with HBV hepatitis,50 patients with hepatic cirrhosis and 50 cases as controls.【Results】 The levels of five kinds of tumor markers in patients with hepatoma group were all significantly higher than other groups（P 0.05）.The positive rates of the five markers,listed from high to low,were AFU（74.67%）,AFP（61.33%）,TSGF（53.33%）,CEA（12.0%） and CA199（11.33%） respectively in 150 patients with liver carcinoma.The detection positive rates of the liver carcinoma can be increased to 97.33% by combination detection with five tumor markers.In 58 hepatoma patients with AFP negative,the positive rates of the four markers were AFU（63.79%）,TSGF（65.52%）,CEA（27.59%） and CA199（22.41%） respectively.The positive rates were 93.10% by combination detection with four tumor markers.It was significantly higher than single marker（P 0.01）.【Conclusion】 Five kinds of TM combination detection can increase the positive detection rate of hepatoma,and will be helpful in the diagnosis of hepatoma.