SA与AFP在肝癌和肝硬化鉴别中的互补性

COMPLEMENTARY VALUE OF SERUM SA AND AFP IN DISTINGUISHING HEPATO—CARCINOMA FROM CIRRHOSIS

应用甲种胎儿蛋白(AFP)单一指标对临床与病理学确诊的原发性肝细胞癌56例及肝硬化40例进行观察表明,AFP 浓度≥400ng/ml 为阳性。具有较高的特异性≥90%,但灵敏度较低,仅为≤50%。如降低 AFP 浓度≥300ng/ml 为阳性,灵敏度虽可改善,但各种肝病显著影响其特异性。血清唾液酸(SA)能早期反映各类癌细胞的增殖、分化及浸润转移;表明病情严重程度,有利于疗效监控及预后判断。尽管 SA 不是一项肝癌特异性指标,但充分显示了其价值。灵敏度≥75%,特异性≥85%,诊断效率为≥63%,明显优于 AFP的诊断效率(45%),将与特异性较高的 AFP 相结合,应用双指标的互补性效应,显著提高了诊断效率。

An observation was made on the AFP content of 56 patients with primary hepato—cellular carcinoma and that of 40 patients with hepatocirrhosis.The diagnosis of all these cases had been clinically and pathologically established.The results showed that when the concentration of AFP≥400ng/ml,hepato— carcinoma was positive.AFP was specific highly to the carcinoma(≥90%),but its sensitivity was low(≤ 50%).Serum SA can reflect the propagation,division,infiltration and transfer of the cancer cells in early time. tIt was also suggested that SA was beneficial to distinguish the hepato—carcinoma from the hepato—cirrhosis because it was sensitive,specific and efficient.When SA and AFP were combined in the clinical diagnosis together,the correct rate of diagnosis of these two diseases was raised obviously.