Alpha-fetoprotein:A controversial prognostic biomarker for small hepatocellular carcinoma

The assessment of the prognosis in patients with early hepatocellular carcinoma represents a hot-topic issue that requires further improvements and clarifications. The life expectancy of the patients has been shown to depend on several clinical and histological parameters (such as patient's general conditions,macroscopic tumor morphology and histopathology).Recently,the prognostic role of some biomarkers[i.e.,alpha-fetoprotein(AFP)] has been also investigated with controversial findings mainly on the assessment of patient survival.The study by Giannini et al failed to show a prognostic value of AFP on survival of patients with well-compensated cirrhosis and small hepatocellular carcinoma.Since the study presents some limitations,a larger clinical trial is needed to clarify the potential prognostic role of serum AFP levels in these patients.

血清及腹腔积液肿瘤标志物联合检测的临床应用价值

目的探讨血清及腹腔积液甲胎蛋白(AFP)、癌胚抗原(CEA)、糖蛋白抗原199(CA199)、CA724、CA125联合检测对良、恶性腹腔积液鉴别诊断的价值。方法选择2011年1月至2013年10月确诊为腹腔积液患者144例,分为良性组(79例)和恶性组(65例),对所有患者抽取腹腔积液标本和采集血清标本,采用化学发光法测定AFP和CEA,采用免疫放射分析法测定CA199、CA724和CA125。比较两组患者血清及腹腔积液肿瘤标志物的水平以及单项检测和联合检测的准确性。结果恶性组患者血清及腹腔积液中AFP、CEA、CA199水平均值明显高于良性组,差异有统计学意义(P<0.01)。血清及腹腔积液AFP、CEA及CA199联合检测恶性腹腔积液的准确性分别为79.17%、85.42%;血清及腹腔积液CEA、CA125及CA199联合检测恶性腹腔积液的准确性分别为77.78%、81.25%,血清及腹腔积液CEA、CA199及CA724联合检测恶性腹腔积液的准确性分别为77.78%、84.72%。多项肿瘤标志物联合检测恶性腹腔积液的诊断准确性显著高于单项检测,差异均有统计学意义(P<0.05)。结论血清及腹腔积液肿瘤标志物联合检测可提高恶性腹腔积液诊断的敏感性和准确性。