血清CEA、CA125、CA199及AFP联合检测在诊断不同肝病的临床应用价值

Clinical Value of Combined Detection of Serum CEA,CA125,CA199 and AFP in the Diagnosis of Different Liver Diseases

目的:探讨血清癌胚抗原(carcinoembryonic antigen,CEA)、血清癌胚抗原(cancer antigen125,CA125)、癌抗原(cancer antigen 199,CA199)及甲胎蛋白(α-fetoprotein,AFP)联合检测在诊断不同肝病的临床应用价值。方法:选取本院2015年6月-2017年6月收治的肝炎患者60例为肝炎组,肝硬化患者60例为肝硬化组,肝癌患者60例为肝癌组,另选取健康体检者60例为对照组。比较各组入院时血清CEA、CA125、CA199及AFP水平,比较肝硬化组不同肝功能分级者、不同病因者的血清CEA、CA125、CA199及AFP水平。结果:肝癌组CEA、CA125、CA199及AFP水平均明显高于肝炎组、肝硬化组及对照组,且肝炎组、肝硬化组四种血清标志物水平均高于对照组,比较差异均有统计学意义(P<0.05);肝硬化Child-Pugh B级、C级患者血清CEA、CA125、CA199及AFP水平均明显高于A级,且C级患者四种血清标志物水平均高于B级,比较差异均有统计学意义(P<0.05);胆汁性肝硬化患者血清CEA水平明显高于病毒性及酒精性肝硬化患者(P<0.05);病毒性、胆汁性肝硬化患者血清CA125和CA199水平均低于酒精性肝硬化患者(P<0.05);病毒性肝炎肝硬化患者血清AFP水平显著高于酒精性和胆汁性肝硬化患者(P<0.05)。结论:不同肝病血清CEA、CA125、CA199及AFP水平存在差异;且肝硬化患者CEA、CA125、CA199及AFP水平与Child-Pugh分级和不同病因密切相关,血清CEA、CA125、CA199及AFP联合检测对于不同肝病的早期诊断具有重要价值。

Objective:To investigate the clinical value of combined detection of serum carcinoembryonic antigen(CEA),cancer antigen 125(CA125),cancer antigen 199(CA199)andα-fetoprotein(AFP)in the diagnosis of different liver diseases.Method:A total of 60 patients with hepatitis treated in our hospital from June 2017 to June 2015 were selected as hepatitis group,60 liver cirrhosis patients were selected as liver cirrhosis group,60 liver cancer patients were selected as liver cancer group,and 60 healthy persons were selected as control group.The levels of serum CEA,CA125,CA199 and AFP in each group were compared,and the levels of serum CEA,CA125,CA199 and AFP of different liver function classification and different etiological factors in liver cirrhosis group were compared.Result:The levels of CEA,CA125,CA199 and AFP in liver cancer group were significantly higher than those of hepatitis group,the liver cirrhosis group and control group,and the four serum markers in the hepatitis group and the liver cirrhosis group were higher than those of control group,the differences were statistically significant(P<0.05).The levels of serum CEA,CA125,CA199 and AFP in patients with Child-Pugh B and C grade of liver cirrhosis were significantly higher than those of A grade,and the four serum markers in C grade were higher than those of B grade,the differences were statistically significant(P<0.05).The levels of serum CEA in patients with biliary cirrhosis were significantly higher than those of patients with viral hepatitis and alcoholic cirrhosis(P<0.05).The levels of serum CA125 and CA199 in patients with viral biliary cirrhosis were lower than those of patients with alcoholic cirrhosis(P<0.05).The levels of serum AFP in patients with viral hepatitis cirrhosis was significantly higher than those of patients with alcoholic and biliary cirrhosis(P<0.05).Conclusion:The serum levels of CEA,CA125,CA199 and AFP in different liver diseases were different,and the levels of CEA,CA125,CA199 and AFP in patients with liver cirrhosis were closely related to the Child-Pugh classification and different causes.The serum CEA,CA125,CA199 and combined detection had important value for the early diagnosis of different liver diseases.