继发性肝癌与原发性肝癌血清AFP检测的临床意义

Clinical significance of AFP detection for secondary liver cancer and primary liver cancer LlU Zhen-hai. CHEN Xing-hai Hospital, Zhongshan 528415, China

目的分析探讨血清甲胎蛋白（AFP）在对继发性肝癌和原发性肝癌临床诊断的意义和价值。方法选取2009年7月-2010年12月来我院进行诊断并确诊的87例肝癌患者，进行血清AFP检测，并记录患者血清AFP〉20μg／L，及〉400μg／L，其中〉400μg／L为阳性。结果原发性肝癌患者血清AFP〉20μg／L有46例，阳性数即血清甲胎蛋白〉400μg／L有39例，阳性率为81．25％；而在继发性肝癌患者中血清AFP〉20μg／L有19例，血清AFP阳性数10例，阳性率为25．64％。原发性肝癌的血清AFP阳性率明显高于继发性肝癌，两组患者的诊断阳性率差异具有显著性（P〈0．05）。结论血清甲胎蛋白诊断原发性肝癌的准确率较继发性肝癌高，但敏感性，特异性均不够理想，可辅助其他实验室诊断提高肝癌的确诊率。

Objective To explore the clinical diagnosis meaning and value of AFP on secondary liver cancer and primary liver cancer. Method Selected 87 patients diagnosed with hver cancer from July 2009 to December 2010 in our hospital. Tested their serum AFP and recorded their serum AFP〉 20 μg/L, and 〉 400 μg/L. When serum AEP 〉 400 μg/L, it is positive. Result 46 primary liver cancer patients＇ serum AFP〉 20 μg/L. 39 patients were positive（serum AFP 〉400 μg/L） ; positive rate was 81.25%. And among the secondary liver cancer patients, 19 cases＇ serum alphafetoprotein 〉 20 μg/L; 10 cases＇ Serum AFP was positive; the positive rate was 25.64%. Primary liver cancer＇ serum alphafetoprotein positive rate was obviously higher than secondary liver cancer＇. There was significant difference on positive diagnosis rate between the two groups（P〈0.05）. Conclusion Using serum AFP to diagnose primary liver cancer has a higher accuracy rate than to diagnose secondary liver cancer, but its sensitivity and specificity are insufficient ideal; assisting with other laboratory diagnosis can improve liver cancer diagnosis rate.