联合检测AFP和CEA肿瘤标志物对原发性肝癌与转移性肝癌的鉴别诊断价值  

Diagnostic Value in Distinguishing Primary Hepatic Carcinoma from Metastatic Hepatic Carcinoma by Combined Determination of Alpha Fetoprotein and Carcinoembryonic Antigen

作　　者：刘成桂[1] 张瑞珍[1] 丁少川[1] 马晋[1] 吴春香[1] 刘于嵩[1] 

机构地区：[1]四川省医学科学院附属医院检验科,成都610101

出　　处：《现代检验医学杂志》2009年第6期117-120,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨联合检测甲胎蛋白（AFP）和癌胚抗原（CEA）对原发性肝癌（PHC）与转移性肝癌（MHC）的鉴别诊断价值。方法用微粒子化学发光免疫分析法检测132例PHC，47例MHC和100例健康对照者血清AFP和CEA。结果PHC患者AFP极度升高，达3685．2±5964．3μg／L，明显比MHC组（25．2±81．6μg／L）和健康对照组（4．1±2．6μg／L）高（F=27．8，P〈0．01），81．8％的PHC患者AFP阳性，其中76．5％的患者AFP〉500μg／L；12．8％的MHC患者AFP阳性，但均〈200μg／L。AFP对PHC诊断的灵敏度（SE），特异度（SP），阳性预测值（PPV），阴性预测值（NPV），准确度（AC）分别为81．8％，87．2％，94．7％，63．1％，83．2％；CEA对MHC诊断的SE，SP，PPV，NPV，AC分别为72．3％，53．8％，35．8％，84．5％，58．7％。结论联合检测AFP和CEA能较好地诊断和鉴别诊断PHC与MHC。Objective To study the diagnostic value in distinguishing primary hepatic carcinoma （PHC） and metastatic hepatic carcinoma （MHC） by combined determination of alpha fetoprotein （AFP） and carcinoembryonic antigen （CEA）. Methods The serum levels of AFP and CEA in 132 patients with PHC and 4T patients with MHC and 100 healthy subjects were measured,respectively,by microparticle chemiluminescent immunoassay. Results The study revealed that patients with PHC had significantly higher levels of AFP 3 685.2±5 964.3μg/L compared to that with MHC group （25.2±81.6μg/L） and controls （4.1±2.6 μg/L） [analysis of variance（ANOVA） ,P〈0.01]. The positive ratio of AFP in PHC group was 81.8% ,among AFP of 76.5% PHC patients was greater than 500 μg/L. However,the positive ratio of AFP in MHC group was 12.8% and AFP of all patients with MHC was less than 200 μg/L, The diagnostic efficiency of AFP for PHC was 81.8% for sensitivity （SE）,87.2% for specificity （SP）,94.7% for positive predictive value （PPV）,63.1% for negative predictive value （NPV） and 83.2% for accuracy （AC）,respectively. The diagnostic efficiency of CEA for MHC was T2.3% for SE,53.8% for SP,35.8% for PPV,84. 5% for NPV and 58. 7% for AC,respectively. Conclusion Combined detection of AFP and CEA can provide better diagnostic efficiency in distinguishing PHC from MHC.

关 键 词：肿瘤标志物 甲胎蛋白 癌胚抗原 原发性肝癌 转移性肝癌 

分 类 号：R730.45[医药卫生—肿瘤]