血清AFP,CEA,CA125单独或联合检测对原发性肝癌早期诊断的临床价值研究

Clinical value of the combination of serum AFP,CEA,CA125 Levels in the Diagnosis of Early Stage of Primary Hepatic Cancer

目的:探讨血清中甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原125(CA125)单独以及联合检测对于原发性肝癌的早期诊断临床价值。方法:选择2012年1月~2016年6月在我院检验科确诊的120例原发性肝癌患者作为观察组,并以80例健康志愿者作为对照组,检测和比较两组的AFP、CEA和CA125水平,分析血清AFP、CEA、CA125单项及联合检测检出原发性肝癌的阳性率和约登指数。结果:观察组血清AFP(319.53±35.78 ng/mL)、CEA(81.4±27.8 ng/mL)、CA125(20.67±4.61 ng/mL)水平均明显高于健康对照组(P<0.05)。血清AFP、CEA、CA125在单独检测时诊断原发性肝癌的敏感性分别为65%(78/120)、75%(90/120)和60%(72/120),而三者的联合检测能够使检测的敏感性达到92%(112/120),显著高于单独检测时的敏感度(P<0.05)。血清AFP、CEA、CA125单项检测约登指数均显著低于联合检测(P<0.05)。结论:相较于血清AFP、CEA、CA125的单独检测,三者联合检测可明显提高原发性肝癌的检出率。

Objective： To investigate the clinical value of serum alpha fetoprotein （AFP）, carcinoma-embryonic antigen （CEA） and cancer antigen 125 （CA125） in the diagnoss of liver cirrhosis and primary hepatic cancer （PHC）. Methods： The clinical information of 120 cases of PHC and 80 normal contral persons from January 2012 to June 2016 in our department were retrospectively analyzed. The serum levels of AFP, CEA and CA125 were detected and compared. Then the positive detection rate and youden index of single or combined detection ofAFP, CEA and CA125 for PHC were analyzed. Results： The serum levels of AFP （319.53±35.78 ng/mL）, CEA （81.4±27.8 ng/mL）, CA125 （20.67±4.61 ng/mL） in PHC were significantly higher than those in the hepatitis and healthy individuals （P〈0.05）. The positive detection rate of serum AFP, CEA and CA125 for PHC was 65%, 75% and 60% respectively. Combined assay of AFP, CEA and CA125 increased the detecting rate up to 92% （P〈0.05）. Conclusion： The combined detection ofAFP, CEA and CA125 could significantly enhance the detection rate for PHC than any single marker examination.