原发性肝细胞癌患者血清AFP、CEA和CA50的研究

Investigation of Serum AFP, CEA and CA50 in Patients with Primary Hepatocellular Cancer

为研究原发性肝细胞癌(PHC)血清一些肿瘤标志的变化及临床意义,本文用放射免疫法测定PHC31例,非胰岛素依赖性糖尿病(NIDDM)24例患者血清甲胎蛋白(AFP)、癌胚抗原(CEA)和糖类抗原50(CA50)含量,并以23例正常人作对照,同时测定一些相关指标。PHC肿瘤大小用B超确定,个别患者用CT确定。结果PHC患者血清AFP(332.8±126.11对10.75±5.47ng/L),CA50(42.85±19.28对20.94±6.20U/ml),均明显高于正常对照(P<0.01),AFP升高与CA50呈正相关,而AFP和CA50含量与PHC的肿瘤大小也呈正相关(P<0.05),但与Child分级无关(P>0.05)。AFP阳性例数29例,敏感性93％,特异性87％,正确性88％。CA50阳性18例分别为58％、78％和76％。NIDDM患者仅CA50升高(25.22±5.16U/ml,P<0.05),且与血糖浓度(11.65±1.94mmol/L)无关(P>0.05)。研究提示联合测定血清AFP、CA50对诊断PHC是敏感、特异而正确的。

Serum AFP, CEA and CA50 levels were measured in 31 patients with PHC, 24patients with non-insulin-dependent diabetes mellitus (NIDDM) and 23 normal sub-jects. In comparison with normal subjects, a significant increase in the serum levelsof the primary hepatocellular carcinoma (PHC) were observed: AFP 332.8±126.11 vs10.75±5.47ng/L P<0.01; CA50 42.85±19.28 vs 20.94±6.20U/ml, P<0.01; AFP levelscorrelated with CA50(r=0.387 6, P<0.05), and levels of AFP, CA50 were related tothe size of tumor(r=0.414 9, 0.3918, P<0.05, respectively). In the diagnosis of PHC,the sensitivity of serum AFP determination was 93%, specificity 87% and accuracy88%, and of CA50 58% and 76%, respectively. But in 24 patients with NIDDM onlyserum CA50 increased (25.22±5.16U/ml, P<0.05). It was suggested that serum AFPand CA50 served a useful and sensitive cancer marker for the diagnosis of PHC.