肿瘤标志物与C-反应蛋白检测诊断原发性肝癌的临床意义

The clinical significance of the detection of tumor markers and C-reactive protein in the diagnosis of primary liver cancer

目的探究多项肿瘤标志物与C-反应蛋白检测在原发性肝癌中的诊断价值,为原发性肝癌的基因靶向治疗提供依据。方法 2017年8月—2019年10月测定对照组、肝硬化组、原发性肝癌组3组研究对象的血清AFP、CEA、AFU、CA125、CA19-9及CRP的阳性率,评估单独或联合检测这6项指标对原发性肝癌的临床诊断价值。结果与对照组和肝硬化组比较,原发性肝癌组患者的血清6项指标水平和表达阳性率均明显增加,差异均有统计学意义(P <0.05)。多发肿瘤组、肿瘤直径≥5 cm组、有淋巴结转移组的6项指标阳性率分别高于单发肿瘤组、肿瘤直径<5 cm组、无淋巴结转移组,差异均具有统计学意义(P <0.05)。6项联合检测的准确性、敏感性和阴性预测值均显著高于单项检测,差异有统计学意义(P <0.05)。结论血清AFP、CEA、AFU、CA125、CA19-9和CRP联合检测可显著提高原发性肝癌诊断的灵敏度、特异度以及正确指数,具有重要的临床指导价值。

Objective To explore the diagnostic value of multiple tumor markers and C-reactive protein detection in primary liver cancer,so as to provide a basis for gene targeted therapy of primary liver cancer. Methods From August 2017 to October2019,the positive rates of serum AFP,CEA,AFU,CA125,CA19-9 and CRP in the control group,liver cirrhosis group,and primary liver cancer group were determined. And the clinical diagnostic values of these 6 indicators alone or in combination were evaluated for primary liver cancer. Results Compared with the control group and the liver cirrhosis group,the serum levels of6 indicators and the positive expression rate of the patients in the primary liver cancer group increased significantly,and the differences were statistically significant( P < 0. 05). The positive rates of the 6 indicators in the multiple tumor group,tumor diameter ≥5 cm group,and lymph node metastasis group were higher than those in the single tumor group,tumor diameter <5 cm group,and no lymph node metastasis group. The differences were statistically significant( P < 0. 05). The accuracy,sensitivity and negative predictive value of the combined detection of 6 indicators were significantly higher than that of the single detection,and the difference was statistically significant( P < 0. 05). Conclusion The combined detection of serum AFP,CEA,AFU,CA125,CA19-9 and CRP can significantly improve the sensitivity,specificity and correct index of the diagnosis of primary liver cancer,which has important clinical guidance value.