肝病患者血清中多项肿瘤标志物联合检测的临床研究

Clinical research on joint detection of multi-tumor markers in sera of patients with liver diseases

目的:探讨肝病患者血清甲胎蛋白(AFP)、癌胚抗原(CEA)、血清铁蛋白(SF)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)、糖类抗原125(CA125)、糖类抗原153(CA153)、糖类抗原199(CA199)及AFP与CEA、CA125、CA153、CA199联合检测在各类肝脏疾病中的临床意义。方法:80例健康体检者为对照组,1000例肝病患者为肝脏疾病组,采用电化学发光分析仪检测AFP、CEA、SF、CA125、CA153、CA199;日立7180全自动生化分析仪检测ALP、GGT,并进行统计学分析。结果:肝癌组369例(36.90%),良性肝病组631例(63.10%),肝癌组AFP、CEA、SF、ALP、GGT、CA125、CA153、CA199与对照组及良性肝病组比较;良性肝病组各项指标与对照组比较,差异均有统计学意义(P<0.05或P<0.01);AFP单独检测特异性为92.09%高于其他检测特异性;多项指标联合检测诊断敏感性最高达98.97%与其他指标敏感性比较,差异均有统计学意义(P<0.05)。结论:AFP联合多项肿瘤标志物可提高对各类肝病的鉴别诊断的准确性,减少漏诊率,具有重要临床意义。

Objective：To explore the role of differential diagnosis of alpha-fetoprotein（AFP）,serum ferritin（SF）,alkaline phosphatase（ALP）,γ-glutamyl transpeptidase（GGT） carbohydrate antigen-125（CA125）,carbohydrate antigen-153（CA153）,carbohydrate antigen-199（CA199） and carcinoembryonic antigen（CEA） in hepatopathy.Methods： 80 healthy volunteers are the control group.1000 cases of patients with liver disease are liver disease group.Electrical chemiluminescent analyzer was used to detect levels of AFP,CEA,SF,CA125,CA153,CA199 and Hitachi 7180 automatic biochemical analyzer was used to detect chroma of ALP,GGT.Then the detection results of the two groups were conducted statistical analysis.Results： In the liver diseases group,there were 369 cases of hepatocellular carcinoma（36.90%） and 631 cases of benign liver diseases（63.10%）.When hepatocellular carcinoma group compared with the control group and benign liver diseases group,benign liver diseases group compared with the control group,the difference of indicators detection both had statistical significances.（P0.05,P0.01 respectively）.The specificity of AFP sole detection was 92.09%,which was higher than that of the detection of other indicators.The highest sensitivity of joint detection of multi-tumor markers can reach 98.97%,and when compared with sensitivities of other indicators,the difference were all had statistical significances（P0.05）.Conclusion： The joint detection of AFP with multi-tumor markers can improve the accuracy of differential diagnosis in various liver diseases and reduce the misdiagnosis.It has important clinical significance.