血清肿瘤标记物联合检测在原发性肝癌早期诊断中的研究与临床应用  

Research and clinical application on combined detection of serum tumor markers in early diagnosis of primary hepatocellular carcinoma

作　　者：徐日[1] 徐风亮[2] 康从利[2] 

机构地区：[1]山东大学药学院,250001 [2]济宁医学院附属日照市人民医院检验科,山东日照276826

出　　处：《中国医师进修杂志》2014年第35期47-50,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨甲胎蛋白（AFP）、高尔基膜蛋白73 （GP73）、血管内皮细胞生长因子（VEGF）和α-L-岩藻糖苷酶（AFU）四项指标联合检测在原发性肝癌早期诊断与监控治疗中的临床应用价值.方法 采用电化学发光法、酶联免疫吸附法检测98例原发性肝癌患者（恶性肿瘤组）治疗前、治疗后3个月血清AFP、GP73、VEGF、AFU等免疫指标水平,与50例肝脏良性病变患者（良性对照组）及50例健康体检者（健康对照组）对照.结果 治疗前恶性肿瘤组血清AFP、GP73、VEGF、AFU水平分别为（219.16 ±56.89） μg/L、（355.42±109.26） μg/L、（88.21±24.22）μg/L、（276.51±83.20）U/L,良性对照组分别为（14.95±3.26）μg,/L、（56.43±15.72）μg/L、（2.68±1.27）μg/L、（25.38±11.17） U/L,健康对照组分别为（14.67±3.07）μg/L、（55.06±14.21）μg/L、（2.36±1.14） μ/L、（24.29±10.10） U/L,恶性肿瘤组与良性对照组和健康对照组比较差异有统计学意义（P＜ 0.01）;治疗后恶性肿瘤组血清AFP等上述四项指标分别为（25.66±8.17） μg/L、（65.32±24.15） μ/L、（4.67±1.89）μg/L、（35.23±12.36） U/L,与治疗前比较差异有统计学意义（P＜0.01）.四项肿瘤标记物联合检测诊断原发性肝癌敏感度为95.92％ （94/98）、准确度为93.24％（138/148）,与各单项检测比较明显提高,差异有统计学意义（P＜0.05）.结论 血清肿瘤标记物联合动态检测可作为原发性肝癌早期诊断和监控治疗的辅助手段.Objective To investigate the value on clinical application of dynamic and combined detection of serum tumor markers alpha-fetoprotein （AFP）,Golgi protein 73 （GP73）,vascular endothelial growth factor （VEGF） and alpha-L-fucosidase （AFU） in early diagnosis and monitoring treatment of primary hepatocellular carcinoma.Methods Serum levels of AFP,GP73,VEGF,AFU in 98 patients with primary hepatocellular carcinoma （the malignant group） before and 3 months after treatment were detected by electrochemiluminescence immunoassay and enzyme-linked immunosorbent assay,which compared with the levels of 50 liver benign lesions （the benign group） and 50 healthy subjects （the normal group）.Results The levels of serum AFP,GP73,VEGF,AFU in the malignant group before treatment were （219.16 ± 56.89） μg/L,（355.42 ± 109.26） μg/L,（88.21 ±24.22） μg/L,（276.51 ±83.20） U/L.These indexes in the benign group were （14.95 ± 3.26） μ g/L,（56.43 ± 15.72） μ g/L,（2.68 ± 1.27） μ g/L,（25.38 ± 11.17）U/L.These indexes in the normal group were （14.67 ± 3.07） μ g/L,（55.06 ± 14.21） μ g/L,（2.36 ± 1.14） μ g/L,（24.29 ± 10.10） U/L.There were statistical differences between the malignant group and the benign group,normal group （P 〈 0.01）.The levels of these indexes after treatment in the malignant group were （25.66 ±8.17） μg/L,（65.32 ±24.15） μg/L,（4.67 ± 1.89） μg/L,（35.23 ± 12.36） U/L,there were statistical differences between before treatment and after treatment （P 〈 0.01）.The sensitivity and accuracy of combined detection of these tumor markers in diagnosis of primary hepatocellular carcinoma were 95.92% （94/98） and 93.24%（138/148）,which were statistically higher than single detection（P〈 0.05）.Conclusion The dynamic and combined detection of serum tumor markers could be applied as supplementary means in early diagnosis and monitoring treatment of primary hepatocellular carcinoma.

关 键 词：肝肿瘤 肿瘤标记 生物学 早期诊断 

分 类 号：R735.7[医药卫生—肿瘤]