四种肿瘤标志物对肝癌诊断的临床意义

The Clinical Significance of Four Tumor Markers in the Diagnosis of Liver Cancer

目的通过联合检测肿瘤标志物CEA、CA125、AFP、CA199在肝癌患者血清中的水平,探讨其在肝癌诊断中的价值。方法选取2016年1月～2018年4月我院收治的75例原发性肝癌患者作为肝癌组,选取同期于我院就诊的脂肪肝、乙型肝炎、肝硬化、肝囊肿患者60例作为肝良性病变组,从同期健康体检者中选取60名作为健康对照组。检测肿瘤标志物CEA、CA125、AFP、CA199水平,对比各组肿瘤标志物检测水平以及四项肿瘤标志物对肝癌单检及联检的敏感性和特异性。结果肝癌组CEA、CA125、AFP、CA199血清水平均高于肝良性病变组和健康对照组,差异具有统计学意义(P<0.05);四种肿瘤标记物的测定数值,肝癌组最高,肝良性病变组次之,健康对照组最低。肝癌组中血清AFP单项检测的敏感性、特异性均高于CEA、CA125和CA199的检测,但四种肿瘤标记物联合检测的敏感性高于每一个单项的敏感性,差异具有统计学意义(P<0.05);四项联合检测的特异性并未出现升高。结论 CEA、CA125、AFP、CA199四种肿瘤标记物对肝癌均有一定诊断价值,联合检测可大大提高灵敏度,对肝癌的早期诊断和鉴别具有重要意义。

Objective To explore the value of the joint detection of serum CEA, CA125, AFP and CA199 to the diagnosis of liver cancer. Methods 75 patients with primary liver cancer admitted to our hospital from January 2016 to April 2018 were selected as the liver cancer group. 60 patients with fatty liver, hepatitis B, cirrhosis and hepatic cysts who were treated in our hospital at the same time were selected as liver benign in the lesion group, 60 healthy subjects were selected as healthy controls from the same period. levels of tumor markers CEA, CA125, AFP and CA199 were detected by Roche cobas e601 electrochemiluminescence method. The detection levels of tumor markers in each group were compared. Sensitivity and specificity of tumor markers for single and joint detection of liver cancer.Results The serum levels of CEA, CA125, AFP and CA199 in liver cancer group were higher than those in benign liver disease group and healthy control group, the difference was statistically significant （P〈0.05）. The value of four tumor markers was the highest in liver cancer group and benign in liver. The lesion group was the second, and the healthy control group was the lowest. The sensitivity and specificity of serum AFP single detection in liver cancer group were higher than those of CEA, CA125 and CA199, but the sensitivity of combined detection of four tumor markers was higher than that of each single item, and the difference was statistically significant （P〈0.05）; the specificity of the four co-tests did not increase.Conclusion The four tumor markers CEA, CA125, AFP and CA199 have certain diagnostic value for liver cancer. Combined detection can greatly improve the sensitivity and is of great significance for the early diagnosis and identification of liver cancer.