原发性肝癌的血清肿瘤标记物研究

STUDY OF PRIMARY LIVER CANCER MARKERS

目的探讨血清肿瘤标志物鉴别诊断肝内胆管癌(ICC)和肝细胞癌(HCC)的临床应用价值。方法收集我科从2003年到2010年,68例HCC和ICC病人的术前血清,测定AFP、CA242、CA199、CEA和CA50血清水平。结果血清AFP,CA199和CA242在两组病人间差异有统计学意义(P<0.05)。联合检测中CA242(+)和AFP(-)检测的特异度和准确度最高,分别为90.3%和83.5%),而其灵敏度也达到70.4%。结论 CA242、CA199和AFP将有助于鉴别ICC和HCC。CA242(+)和AFP(-)的联合检测具有较高特异性诊断和准确性。

Objective To evaluate the clinical value of serum levels of tumor markers in distinguishing intrahepatic cholangiocarcinoma （ICC） form hepatocellular carcinoma （HCC） to promote the diagnosis of ICC. Methods Serum levels of AFP, CAl99, CA242, CEA and CA50 were measured in 31 cases of ICC patients and of 68 cases of ICC patients which under operation in PUMCH. from 2003 to 2010. Results Statistical differences were found in the serum levels of AFP, CA199 and CA242 between those two groups （P 〈 0. 05）. The specificity and accuracy of combined measurement of serum tumor markers CA242 （ ＋ ） and AFP （ - ） were the highest 90. 3% and 83.5% respectively, and its sensitivity was also high 70. 4%. Conclusions The investigation of the AFP, CA199, and CA242 in serum will help to identify ICC from HCC and has great significance to the diagnosis of ICC. Combined measurements can increase the specificity of diagnosis and is valuable in differential diagnosis of ICC.