DWI联合血清肿瘤标志物对肝癌术后转移复发早期的诊断价值  

Value of DWI combined with peripheral serum tumor markers in the early diagnosis of postoperative recurrence and metastasis of hepatocellular carcinoma

作　　者：刘新疆[1,2] 刘敬波[1] 王培源[3] 张虎[1] 王滨[3] 

机构地区：[1]滨州医学院附属医院放射科,山东256603 [2]山东大学医学院,250012 [3]滨州医学院医学影像学教研室,256603

出　　处：《放射学实践》2013年第9期960-963,共4页Radiologic Practice

基　　金：国家自然科学基金项目(81171303;30470518);山东省科技攻关项目(2007GG30002032);山东省1020工程(卫生系统杰出学科带头人)(2006-39)

摘　　要：目的:探讨DWI联合外周血清肿瘤标志物检测对肝癌术后转移复发早期诊断的价值。方法:回顾性分析116例原发性肝癌术后转移复发的病例资料,所有患者均经手术或穿刺活检病理确诊为肝癌。患者均行化学发光法检测血清甲胎蛋白(AFP)、甲胎蛋白异质体3(AFP-L3)、癌相关抗原(CA125、CA199)、癌胚抗原(CEA)水平,其中AFP值均>1210ng/L,所有患者均行MRI常规扫描和DWI扫描。结果:外周血血清肿瘤标志物AFP-L3、CA199、CA125、CEA敏感度及特异度随肿块增大而升高,4项肿瘤标志物联合检测的敏感度及特异度最高。DWI联合4项肿瘤标志物检测的诊断敏感度、特异度可提高到98.4%和95.0%。结论:DWI联合肿瘤标志物检测对肝癌术后转移复发监测敏感有效,为肝癌术后疗效评估和追踪复查提供了一条新途径。Objective：To study the value of of DWI combined with peripheral serum tumor markers in the early diag nosis of postoperative recurrence and metastasis of hepatocellular carcinoma. Methods： 116 cases of postoperative metastasis or recurrence of liver cancer were retrospectively analyzed. All cases were confirmed by surgery or puncture biopsy. The pa tients underwent the chemiluminescence detection of serum alpha fetoprotein （AFP）, alpha-fetoprotein heterogeneity （AFP L3 ）, cancer-associated antigen （CA125, and CA199 ）, earcinoembryonic antigen （CEA） level and DWI, and AFP〉 1210ng/L was observed in all patients for this study. Results：The sensitivity and specificity of serum tumor marker AFP 1.3,CA199, CA125 and CEA increased with enlargement of the tumor. The sensitivity and specificity was the highest in combination of the four tumor markers. The diagnostic sensitivity and specificity of DWI combined with four tumor markers could be in creased to 98.4 Y0 and 95.0%. Conclusion： DW1 combined with tumor markers are sensitive and effective for detection of postoperative metastasis and recurrence of liver cancer. It provides a new way for evaluation of postoperative effective ness and follow-up examination.

关 键 词：肝肿瘤 肿瘤标记 生物学 肿瘤复发 局部 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]