多种肿瘤标记物蛋白芯片检测系统对原发性肝癌的诊断价值

Diagnostic value of multi-tumor marker protein biochip detective system for primary hepatic cancer

目的 研究多种肿瘤标记物蛋白芯片检测系统对原发性肝癌的诊断价值。方法 用该检测系统测定分析 76例原发性肝癌 (PHC)患者 ,5 8例良性肝病患者和 14 5例健康查体者血清中 6种常见肿瘤标记物 (CA199,CEA ,CA2 4 2 ,AFP ,CA12 5及CA15 3)的水平。结果 PHC组的阳性率为 82 .89% ,显著高于良性肝病组 ( 4 1.38% )和健康查体组 ( 4 .83% ,P <0 .0 0 1)。不同分期PHC之间联合检测阳性率存在显著性差异 ,以Ⅳ组阳性率最高 (P =0 .0 11) ,但不同病理类型之间无显著性差异 (P =0 .5 0 6 ) ;不同分期之间AFP血清水平存在显著性差异 (P =0 .0 35 ) ;肝细胞癌及混合癌AFP阳性率高于胆管癌 (P =0 .0 18) ;联合检测在提高诊断敏感性的同时 (P <0 .0 0 1) ,特异性有所下降 (P <0 .0 0 1)。结论 运用蛋白芯片技术联合检测多种肿瘤标记物可以提高PHC诊断的敏感性 。

Objective To evaluate the diagnostic values of multi tumor marker protein biochip detective system for primary hepatic cancer. Methods The serum levels of 6 common used tumor markers, including CA199,CEA,CA242,AFP,CA125 and CA153, were measured with the detective system in 76 primary hepatic cancer patients, 58 patients with benign liver disease and 145 healthy controls. Results The positive rates were 82.89%, 41.38% and 4.83% in primary hepatic cancer, benign liver disease and healthy groups, respectively. The PHC group had significant higher postive rate than that of the controls ( P <0.001). There was significant deference of combinedly measured positive rate in various clinical stagings(χ 2 =11.21, P =0.011), but not in deferent pathologic categories( P =0.506). Serum AFP level correlats strongly with its clinical staging( F = 3.029 , P = 0.035). The postive rate of AFP in hepatocellular and mixed carcinoma were much higher than that in cholangiocarcinoma(χ 2 = 8.09, P = 0.018). Combined measure has higher sensitivity( P <0.001),but specificity decreases( P <0.001).Conclusion Combined measure of multiple serum tumor markers using protein biochip technique can significantly increase the diagnostic sensitivity for primary hepatic cancer. Meanwhile, it is also significant for defining clinical staging and identificating pathologic category.