多种血清标记物联合检测对肝癌诊断的临床意义

CLINICAL VALUE OF THE COMBINED DETECTION OF MULTIPLE SERUM MARKERS IN THE DIAGNOSIS OF LIVER CANCEr

目的探讨血清中腺苷脱氨酶(ADA)、甲胎蛋白(AFP)、铁蛋白(SF)、岩藻糖苷酶(AFU)、糖类抗原(CA199)、癌胚抗原(CEA)、胆汁酸(TBA)、a-抗胰蛋白酶(a-AT)、C-反应蛋白(CRP)、胆碱酯酶(CHE)、碱性磷酸酶(ALP)和谷氨酰转移酶(GGT)12种标记物的含量对肝癌诊疗的临床意义。方法随即筛选肝癌患者、良性肝病患者及健康体检者各45例,分别检测其血清ADA、AFP、SF、AFU、CA199、CEA、TBA、aAT、CRP、CHE、ALP及GGT的含量,统计分析各组间结果差异,并比较12种指标单独或联合检测对肝癌诊断的敏感性和特异性。结果血清ADA、AFP、SF、AFU、CA199、CEA、TBA、a-AT、CRP、CHE、ALP及GGT含量在肝癌患者组明显高于良性肝病患者组及健康体检组,差异无统计学意义(P<0.05);对肝癌的诊断价值方面,单项检测ADA、AFP、SF、AFU、CA199、CEA、TBA、a-AT、CRP、CHE、ALP及GGT的敏感性分别为78%、82%、73%、80%、64%、49%、78%、87%、60%、89%、76%和84%,特异性分别为91%、90%、88%、96%、74%、78%、57%、74%、66%、80%、89%和76%;12项联合检测的敏感性为98%,特异性为56%。结论 12项联合检测提高了肝癌诊断的敏感性,有利于肝癌的早期诊断,降低了对肝癌的漏诊。

Objective To investigate the clinical value of serum of ADA,AFP,SF,AFU,CA199,CEA,TBA,a AT,CRP,CHE,AI.P and GGT in the diagnosis of liver cancer.Methods The levels of Serum ADA,AFP, SF,AFU,CA199,CEA,TBA,a- AT,CRP,CHE,ALP and GGT were detected in 45 cases of liver cancer,45 cases of benign liver disease, and 45 cases of normal controls, and the di[ferences were analyzed among the three groups.The sensitivity and specificity of the twelve indicators （alone or combined detected） were also e- valuated in the diagnosis of liver cancer. Results The levels of Serum ADA, AFP, SF, AFU, CA199, CEA, TBA, a- AT, CRP, CHE, ALP and GGT content of liver cancer cases were significant higher than that of the benign liver disease cases and normal controls （P〈0.05） ; in liver cancer diagnosis,individual detection sensi tivity of 78% ,82% ,73% ,80% ,64% ,49% ,78%,87% ,60%,89%,76%and 84%,respectively; and the spe cificity were 91%,90%0,88%,96%,74%,78%,57%,74%,66%,80%,89% and 76% separately. Twelve joint detection searately sensitivity of 98% and a specificity of 56% .Conclusion Joint detection of the twelve indicators improved the diagnostic sensitivity, which will be conducive to improv the early diagnosis of liver cancer and reduce the missed diagnosis of liver cancer.