联合检测血清AFU、AFP、β_2-MG、CA199及CEA对原发性肝癌诊断的临床意义

Diagnostic value of combined determination of serum AFU, AFP, β_2-MG, CA199 and CEA levels in patients with primary hepatic cancer

目的联合检测血清AFU、AFP、β2-MG、CA199及CEA5项肿瘤标志物以探讨其对肝脏疾病癌变的诊断价值。方法采用电化学发光免疫法及放射免疫法对原发性肝癌组65例、肝硬化组60例、肝炎组46例及健康组58例血清AFU、AFP、β2-MG、CA199及CEA进行联合检测。结果 5项指标浓度水平在原发性肝癌组高于肝硬化组,肝硬化组高于肝炎组,其差异均有统计学意义(P<0.01),肝炎组与健康组比较差异无统计学意义(P>0.05)。此外,5项指标联合检测检出阳性率与3项、2项或单项指标比较在检出原发性肝癌上差异有统计学意义(P<0.01),而在转移性肝癌差异无统计学意义(P>0.05)。结论应用血清AFU、AFP、β2-MG、CA199及CEA5项指标联合检测能提高原发性肝癌的阳性检出率(可达91%以上)。

Objective To investigate the diagnostic value of combined detection of five tumor markers （AFU, AFP,β2-MG, CA199 and CEA） in patients with possible malignant change in liver disorders. Methods Serum AFU, AFP, β2-MG, CA199 and CEA levels were determined with electroehemiluminescence immunoassay （ECLIA） and radioimmunoassay （RIA） in 65 patients with primary hepatic cancer, 15 patients with metastatic liver carcinoma, 60 patients with hepatic cirrhosis, 46 patients with HBV hepatitis and 58 controls. Results The serum levels of AFU, AFP, β2-MG, CA199 and CEA in patients with primary hepatic cancer and hepatic cirrhosis were all significantly high- er than those in controls （P〈0.01）. The serum levels of the five markers in patients with primary hepatic cancer were significantly higher than those in hepatic cirrhosis （P〈0.05）. However, Serum levels of the five markers in patients with hep- atitis were not significantly different rrom those in controls （P〉0.05）. Moreover, positive rate of combined determination of AFU, AFP, β2-MG, CA199 and CEA was significantly higher than that ofAFP, AFP＋AFU, AFU＋AFP＋ β2-MG in patients with primary hepatic cancer （P〈0.01）. However, positive rate of the five markers was not significant different in pa- tients with metastatic liver cancer （P〉0.05）. Conclusion With combined determination ofAFU, AFP, β2-MG, CA199 and CEA, the detection rate of primary hepatic cancer could be enhanced to above 91%.