多种肿瘤标志物对原发性肝癌的诊断价值

Diagnostic value of multiple tumor markers in primary liver cancer

目的:探讨血清中多种肿瘤标志物检测在原发性肝癌的诊断价值。方法:选取2018年9月至2020年6月广西医科大学附属肿瘤医院就诊的原发性肝癌200例和健康体检者120例作为研究对象,采用化学发光微粒子免疫检测法检测癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)、糖类抗原153(CA153)、甲胎蛋白(AFP)含量,酶联免疫法检测热休克蛋白90α(HSP90α)、胸苷激酶1(TK1)含量,采用受试者工作特征曲线(ROC曲线)判断各标志物诊断价值。结果:肝癌组CEA、CA125、CA199、CA153、AFP、HSP90α、TK1均高于正常组(P<0.05)。各项肿瘤标志物指标单独检测对原发性肝癌诊断价值中AFP最优(AUC=0.905,P=0.000),CA199最差(AUC=0.672,P=0.000)。CEA、CA125、CA199、CA153、AFP、HSP90α、TK1最佳阈值分别为2.45 ng/mL、15 U/mL、4.4 U/mL、13 U/mL、4.51 ng/mL、49.9 ng/mL、1.13 pM/L。AFP+HSP90α联合检测肝癌诊断价值高于AFP单独检测(AUC=0.957,P=0.000)。AFP+HSP90α+CA125+CA153+CEA联合检测肝癌诊断价值高于AFP+HSP90α联合检测(AUC=0.981,P=0.003)。结论:AFP+HSP90α联合检测可提高AFP单一诊断价值,以AFP+HSP90α+CA125+CA153+CEA联合检测诊断价值最好。

Objective:To explore the diagnostic value of multiple tumor markers in serum in the detection of primary liver cancer.Methods:A total of 200 primary liver cancer patients(liver cancer group)treated in Guangxi Medical University Affiliated Tumor Hospital from September 2018 to June 2020 and 120 cases of healthy subjects(normal group)were selected.Chemiluminescence microparticle immunoassay was used to detect the levels of carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125(CA125),CA199,CA153,and alphafetoprotein(AFP).Enzyme-linked immunoassay was used to detect heat shock protein 90α(HSP90α)and thymidine kinase 1(TK1)contents.ROC curve was used to evaluate the diagnostic value of each marker.Results:The CEA,CA125,CA199,CA153,AFP,Hsp90αand TK1 levels in the liver cancer group were higher than those in the normal group(P<0.05).Among the tumor markers for primary liver cancer,the diagnosticvalue of AFP was the highest(AUC=0.905,P=0.000),and the diagnosticvalue of CA199 was the lowest(AUC=0.672,P=0.000).The best thresholds for CEA,CA125,CA199,CA153,AFP,Hsp90α,and TK1 were 2.45 ng/mL,15 U/mL,4.4 U/mL,13 U/mL,4.51 ng/mL,49.9 ng/mL,and 1.13 pM/L,respectively.The diagnostic value of AFP combined with HSP90αfor liver cancer was higher than that of AFP alone(AUC=0.957,P=0.000).The diagnostic value of AFP+HSP90α+CA125+CA153+CEA combined detection for liver cancer was higher than that of AFP+HSP90αcombined detection(AUC=0.981,P=0.003).Conclusion:The combined detection of AFP+HSP90αcan improve the diagnostic value,and AFP+HSP90α+CA125+CA153+CEA combined detection has the best diagnostic value.