肝癌与肝炎标志物及相关肿瘤标志物的相关性分析  

Diagnostic Value of HBV-M and Liver Tumor Marker for Primary Hepatic Carcinoma

作　　者：李文伟[1] 马骢[1] 王珍光[1] 靳冰[1] 张海超[1] 冯洁[1] 

机构地区：[1]海军总医院检验科,100037

出　　处：《实用癌症杂志》2010年第5期495-496,共2页The Practical Journal of Cancer

摘　　要：目的探讨乙肝五项、HCV抗体、血清甲胎蛋白(AFP)、CA19-9、CA125、CEA对原发性肝癌的诊断价值。方法对75例原发性肝癌患者分别测定乙肝五项、HCV抗体、肝脏肿瘤血清标志物AFP、CA199、CA125、CEA。结果 5例原发性肝癌患者中,HBsAg阳性45例(60.0%),HCV抗体阳性16例(21.3%),HBsAg并HCV抗体双阳性3例(4.0%);乙肝五项(HBV-M)不同组合模式中,HBsAg、HBeAb、HBcAb三项阳性(小三阳)20例,HBsAg、HBeAg、HBcAb阳性(大三阳)9例,HBsAg、HBcAb两项阳性14例。AFP、CA19-9、CA125、CEA对肝癌诊断的灵敏度依次为AFP(68.0%),CA19-9(34.6%),CA125(33.3%),CEA(30.7%),四项联合检测对肝癌诊断的灵敏度可提高至80.0%。结论肝癌的发生与HBV有着非常密切的关系,HBsAg、HBeAb、HBcAb三项阳性(小三阳)患者应视为的高危人群。在肝癌患者中,肝癌的单项肿瘤标志物检测应首选阳性率最高的AFP,多种肿瘤标志物联合检测对肝癌的诊断具有重要价值。Objective To detect HBV-M,HCV-A,liver tumor markers AFP,CA19-9,CA125,CEA and discuss their value in the diagnosis of primary hepatic carcinoma.Methods The HBV-M,HCV-Ab,AFP,CA199,CA125,and CEA were detected in 75 patients with primary hepatic carcinoma.Results The positive rate of HBsAg,HCV-Ab and both HBsAg and HCV-Ab was 60.0%,21.3% and 4.0%,respectively.In HBV-M tests,HBsAg,HBeAb and HBcAg were all positive in 20,HBsAg,HBeAg and HBcAg were all positive in 9,and HBsAg and HBcAg were both positive in 14.The sensitivity of AFP,CA19-9,CA125 and CEA were 68.0%,34.6%,33.3%,and 30.7%,respectively in the diagnosis of primary hepatic carcinoma.This sensitivity was increased to 80.0% if AFP,CA19-9,CA125 and CEA were detected together.Conclusion There was positive correlation between the primary hepatic carcinoma and HBV infection,and patients with positive HBsAg,HBeAb and HBcAg might consider as high-risk group.The most sensitive marker is AFP,whereas combined detection of the tumor markers is preferred in the diagnosis of primary hepatic carcinoma.

关 键 词：肝细胞癌 乙肝五项 肝炎抗体 肿瘤标志物 

分 类 号：R735.7[医药卫生—肿瘤]