多肿瘤标志物蛋白芯片检测中AFP在恶性肿瘤中的诊断价值

Systematic analysis of alpha-fetoprotein within serum multiple tumor markers chip and its clinical significance in malignant tumor diagnosis

目的分析在各组人群中多肿瘤标志物蛋白芯片中甲胎蛋白(AFP)的表达情况以及与其他指标的伴随情况,并探讨其临床意义。方法收集整理该院2003年12月至2011年7月可供分析的25 076例多肿瘤标志物蛋白芯片检测结果,并分析蛋白芯片中AFP在各组人群表达情况和在各种肿瘤中的升高情况,以及AFP升高伴随其他检测指标升高在肿瘤中的分布情况。结果在恶性肿瘤患者中AFP的升高率(17.3%)明显较良性病变患者(15.3%)及正常体检者(12.1%)高,其中,AFP的升高率最高的为肝癌(54.3%),且差异有统计学意义(P<0.01);其次是卵巢癌与胃癌,它们的升高率分别为18.8%和17.1%;AFP伴随升高指标以CA125最为常见,其次为CA199、CEA、Ferritin、CA242、CA15-3,CA242和CA15-3间比较差异无统计学意义(P>0.01)。AFP/CA125伴随最常见于胰腺癌(60.5%)和卵巢癌(46.2%),AFP/CA19-9伴随最常见于胰腺癌(58.1%)和肝癌(43.7%)。AFP+CA19-9+CA125联合最常见于肝癌(17.9%)。结论 AFP单项指标升高对肝癌的诊断具有较高价值,AFP伴随或联合CA19-9、CA125有助于提高胰腺癌和卵巢癌的诊断。

Objective To investigate the expression of alpha-fetoprotein（AFP） in various people and situations along with other item of multiple tumor marker protein chip, and to explore its clinical significance. Methods Totally 25 076 cases detected with multiple tumor markers chip from December 2003 and July 2011 were collected. The expression of AFP and its combination with other item of multiple tumor marker protein chip were analyzed in malignant tumors and other people. Results Elevated AFP in patients with malignant tumors（17.30%） was significantly higher than in benign lesions（15.3 % ） and normal persons（12.1 % ）, among them,the AFP rise rate was highest for liver cancer （54.3 %）,and the difference was statistically significant （P〈0.01）, followed by ovarian cancer（18. 8%） and gastric cancer（17.1%）. The positive of AFP was commonly combined with other item elevated in patients with malignant tumors. The most common accompanied item was CA125 ,followed by CA199 ,CEA,Ferritin,CA242, CA15-3,there was no statistically significant between CA242 and CA15-3 （P〉0.05）. AFP/CA125 was most common pancreatic cancer （60.5%） and ovarian cancer （46.2%）,AFP/CA19-9 was most common in pancreatic cancer （58. 1%） and liver cancer （43.7%）. AFP ＋CA19-9 ＋ CA125 was most common in liver cancer （17.9%）. Conclusion AFP increase alone was significantly valuable to diagnosis liver cancer,moreover it combined with CA19-9 or CA125 may help to improve the positive rate in pancreatic and ovarian cancer.