CA199、CEA在肝癌中诊断价值及与LVD和MVD相关性分析

The diagnostic value of CA199 and CEA in liver cancer and their correlation with LVD and MVD

目的探究糖链抗原199(carbohydrate antigen 199,CA199)、癌胚抗原(carcinoembryonic antigen,CEA)在肝癌中的诊断价值,并分析CA199、CEA水平与淋巴管密度(lymphatic vessel density,LVD)、微血管密度(microvessel density,MVD)的相关性。方法选择2020年4月至2021年4月在我院确诊的103例肝癌患者为研究组,另选50例同期于我院确诊的良性肝脏病变患者为对照组,分别检测两组患者血清CA199和CEA水平,依据Weidner法计算两组患者肝组织MVD及LVD,对比两组患者上述指标组间差异,分析肝癌患者血清CA199、CEA同临床特征的相关性,CA199、CEA同其病理特征相关性,Spearman分析CA199、CEA与LVD、MVD的相关性,最后绘制CA199和CEA对肝癌的诊断ROC曲线图并计算其曲线下面积(area under curve,AUC)。结果研究组患者的血清CA199及CEA水平均明显的高于对照组,研究组肝癌组织LVD和MVD水平均明显高于对照组肝组织(P<0.05);肝癌患者的临床分期、分化程度、淋巴结转移及肝内转移均与CA199和CEA的表达有相关性(P<0.05);CA199与肝癌组织LVD、MVD均呈正相关(r=0.8860、0.8872,P<0.05),CEA与肝癌组织LVD、MVD均呈正相关(r=0.7287、0.8276,P<0.05);以21.50 U/ml为截断点,CA199对肝癌的诊断AUC为0.8349(P=0.0006),以6.80μg/L为截断点,CEA对肝癌的诊断AUC为0.8981(P<0.0001)。结论肝癌患者血清CA199和CEA水平异常升高,与肝癌组织中的LVD和MVD均呈明显正相关性,可以考虑将CA199和CEA应用于肝癌的临床诊断鉴别中。

Objective To investigate the diagnostic value of carbohydrate antigen 199(CA199)and carcinoembryonic antigen(CEA)in liver cancer,and to analyze the correlation between CA199 and CEA levels and lymphatic vessel density(LVD)and microvessel density(MVD).Methods 103 patients with liver cancer diagnosed in our hospital from Apr.2020 to Apr.2021 were selected as the study group,and 50 patients with benign liver lesions diagnosed in our hospital at the same time were selected as the control group.The levels of serum CA199 and CEA in the two groups were detected respectively.The MVD and LVD of liver tissue in the two groups were calculated according to Weidner method,and the differences between the two groups were compared.The correlation between serum CA199 and CEA and clinicopathological features,CA199 and CEA and their pathological features were analyzed.Spearman analyzed the correlation between CA199,CEA and LVD,MVD.Finally,the ROC curve of CA199 and CEA in the diagnosis of liver cancer was drawn and the area under the curve(AUC)was calculated.Results The levels of serum CA199 and CEA in the study group were significantly higher than those in the control group.The levels of LVD and MVD in the study group were significantly higher than those in the control group(P<0.05);The clinical stage,degree of differentiation,lymph node metastasis and intrahepatic metastasis were closely related to the expression of CA199 and CEA(P<0.05);CA199 was positively correlated with LVD and MVD in liver cancer(r=0.8860,0.8872,P<0.05),and CEA was positively correlated with LVD and MVD in liver cancer(r=0.7287,0.8276,P<0.05);Taking 21.50 U/ml as the cutoff point,the diagnostic AUC of CA199 for liver cancer was 0.8349(P=0.0006)and taking 6.80μg/L as the cutoff point,and the AUC of CEA in the diagnosis of liver cancer was 0.8981(P<0.0001).Conclusion The levels of serum CA199 and CEA in patients with liver cancer are abnormally increased,which is positively correlated with LVD and MVD in liver cancer.CA199 and CEA can be considered to be used in the clinical diagnosis and differentiation of liver cancer.