AFP、CA19-9、CEA联合检测对原发性肝癌的早期诊断价值

The Value of Combined Detection of AFP,CA19-9 and CEA in the Early Diagnosis of Primary Liver Cancer

目的研究AFP、CA19-9、CEA联合检测在原发性肝癌的早期诊断中的临床应用价值,为临床提供可靠的依据。方法采取2019年1—12月该院收治的无肝脏疾病的30名健康人员、15例慢性乙型肝炎患者、15例肝硬化患者、15例转移性肝癌患者及40例原发性肝癌患者的血液,检测每组的AFP、CEA、CA19-9的水平,然后进行对比分析。结果经过检测,肝硬化组、原发性肝癌组、转移性肝癌组的AFP检测水平均高于健康组,与健康组比较差异有统计学意义(P<0.05),原发性肝癌组、转移性肝癌组的CEA及CA19-9检测水平均高于健康组,与健康组比较差异有统计学意义(P<0.05),慢性乙型肝炎组的AFP、CEA、CA19-9的检测水平与健康组相比较,差异无统计学意义(P>0.05)。肝硬化组、原发性肝癌组、转移性肝癌组的AFP、CEA、CA19-9的阳性率与健康组比较,差异有统计学意义(P<0.05),慢性乙型肝炎组AFP、CEA、CA19-9的阳性率与健康组比较,差异无统计学意义(P>0.05),原发性肝癌组AFP+CEA+CA19-9联合检出阳性率高达90.0%,健康组为3.33%,慢性乙型肝炎组为15.0%,原发性肝癌AFP+CEA+CA19-9联合检出阳性率明显高于健康组及慢性乙型肝炎组,差异有统计学意义(P<0.05)。AFP、CEA、CA19-9的单项检测原发性肝癌的准确度、特异度及敏感度均低于联合检测,差异有统计学意义(P<0.05)。结论原发性肝癌患者的AFP、CA19-9、CEA水平均高于健康及普通肝病患者,联合检测的准确度、灵敏度及特异性均高于单项检测,具有很高的早期诊断价值,患者误诊率低,保障了患者生命安全,适用于原发性肝癌的早期诊断中。

Objective To study the clinical application value of the combined detection of AFP,CA19-9 and CEA in the early diagnosis of primary liver cancer,and to provide a reliable basis for the clinic.Methods 30 healthy people without liver disease,15 patients with chronic hepatitis B,15 patients with liver cirrhosis,15 patients with metastatic liver cancer and 40 patients with primary liver disease admitted to our hospital from January to December 2019 of the blood of patients with liver cancer was tested for the levels of AFP,CEA,and CA19-9 in each group,and then a comparative analysis was performed.Results After testing,the AFP detection level of the cirrhosis group,primary liver cancer group,and metastatic liver cancer group was higher than that of the healthy group,and the difference was statistically significant(P<0.05).The primary liver cancer group,the detection levels of CEA and CA19-9 in the metastatic liver cancer group were higher than those in the healthy group,and the difference was statistically significant(P<0.05).The detection levels of AFP,CEA and CA19-9 in the chronic hepatitis B group were compared with those in the healthy group,the difference was not statistically significant(P>0.05).The positive rates of AFP,CEA,and CA19-9 in the liver cirrhosis group,primary liver cancer group,and metastatic liver cancer group were different from them in the healthy group,the difference was statistically significant(P<0.05).The positive rates of AFP,CEA,and CA19-9 in the chronic hepatitis B group were compared.Compared with the healthy group,the difference was not statistically significant(P>0.05).The combined detection rate of AFP+CEA+CA19-9 in the primary liver cancer group was as high as 90.0%,the healthy group was 3.33%,and the chronic hepatitis B group was 15.0%,the positive rate of combined detection of primary liver cancer AFP+CEA+CA19-9 was significantly higher than that of the healthy group and the chronic hepatitis B group,and the difference was statistically significant(P<0.05).The accuracy,specificity and sensitivity of AFP,CEA,and CA19-9 in the single detection of primary liver cancer were lower than the combined detection,and the difference was statistically significant(P<0.05).Conclusion The levels of AFP,CA19-9 and CEA in patients with primary liver cancer are higher than those of healthy and common liver disease patients.The accuracy,sensitivity and specificity of combined detection are higher than those of single detection,which has a high value for early diagnosis.The misdiagnosis rate is low,which guarantees the safety of patients'lives,and is appropriate to the early diagnosis of primary liver cancer.