血清肿瘤标志物检测对肝癌及转移患者的临床意义

Clinical Significance of Serum Tumor Markers in Detection Liver Cancer and its Metastases

目的研究血清学检测指标在鉴别原发性肝癌与转移的诊断价值。方法分别测定120例原发性肝癌患者组,120例原发性肝癌转移患者组及120例无肝转移的癌症患者组血清中ALT、AST、ALP、TBIL、DBIL、GGT、CHF、AFP、CA199、CEA、AFU、SF的水平,采用方差分析和LSD检验进行统计学分析,糖类抗原199(carbohydrate antigen 199,CA199)、癌胚抗原(carcinoembryonic antigen,CEA)、甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)和铁蛋白(SF)联合检测对原发性肝癌及肝癌转移的诊断价值。结果 1原发性肝癌组,肝癌转移组血清ALT、AST、ALP、GGT、CA199、CEA、SF、AFP及AFU水平差异有统计学意义(P<0.05)。2根据原发性肝癌组和肝癌转移组CA199、CEA、AFP、AFU和SF的分析判断,CA199、AFP对原发性肝癌诊断有一定的准确性,CEA、AFU和SF对鉴别原发性肝癌与肝癌转移有一定诊断价值。结论检测血清AFP、CA199、CEA、AFU、SF水平可对原发性肝癌的诊断及是否发生肝癌转移提供一定的参考价值,并为进一步临床诊治提供参考依据。

Objective To investigate the clinical value of serum tumor markers in identification of liver cancers and its metastases.Methods We detected the serum levels of ALT,AST,ALP,TBIL,DBIL,GGT,CHE,CA199,CEA,AFU,SF,and AFP in 120 cases of primary hepatic carcinoma（PHC）,120 cases of hepatic carcinoma with lung 、bone、brain metastases,and 120 control cases no liver metastases.Analysis of Variance and LSD test were used.A combined detection of AFU,SF and AFP was also evaluated.Results The serum levels of AST,ALP,GGT,CA199,CEA,AFP and AFU of the PHC and metastatic groups were statistically different（P〈0.05）.AFP and CA199 performed well in the diagnosis of PHC;whereas SF and AFU had some diagnostic value in differentiating primary and metastatic cancers.Conclusion The combined testing of serum CA199,CEA,AFP,AFU,and SF can provide preliminary diagnosis of liver metastasis and differential diagnosis of PHC and metastatic cancers.