血清AFP、AFU、CEA、GP73及糖链抗原系列联合检测对于早期原发性肝癌的诊断价值  

Value of Combined Detection of Serum AFP,AFU,CEA,GP73 and Carbohydrate Antigen in the Diagnosis of Early Primary Liver Cancer

作　　者：郝磊[1] 郝坤 

机构地区：[1]青岛海慈医疗集团,266000 [2]山东省青岛市商业职工医院,266000

出　　处：《实用癌症杂志》2017年第10期1609-1612,共4页The Practical Journal of Cancer

摘　　要：目的探讨血清肿瘤标志物联合应用在原发性肝癌诊断中的临床价值。方法收集经体检和影像学检查高度怀疑肝癌原发性肝癌患者82例,同时采集肝硬化患者73例入组肝硬化对照组。选取甲胎蛋白(α-fetoprotein,AFP)、α-L-岩藻糖苷酶(AFU)、癌胚抗原(carcino-embryonic antigen,CEA)、糖链抗原系列(CA12,CA153,CA199)和高尔基体膜蛋白73(GP73)作为血清肿瘤标志物研究对象,AFP、CA系列、CEA采用电化学发光法检测;GP73和AFU采用酶显色法进行检测。测定82例疑似原发性肝癌患者、73例肝硬化患者和80例同期体检人群并证实不存在上述疾病的健康对照人群中上述血清标志物水平。结果肝癌组中,AFP、AFU、CEA、CA125、CA199和GP73水平与正常对照组比较,均有统计学差异(P<0.01);曲线下面积(AUC)分别为(95%可信区间)0.827,0.787,0.711,0.791,0.830,0.812,0.817,其中AFP和CA125的AUC最大。单项检测的敏感度均低于联合血清标志物检测的敏感度,随着检验种类的增加,敏感性显著升高,差异有统计学意义。结论多种血清标志物联合检测对肝癌的早期诊断确有一定临床价值,但多种血清肿瘤标志物共同检测在提高灵敏度的同时一定程度上降低了特异性。Objective To investigate the clinical value of serum tumor markers in the diagnosis of primary liver cancer. Methods A total of 82 patients with hepatocellular carcinoma （HCC） who were highly diagnosed by physical examination and imaging examination were collected, and 73 patients with cirrhosis were enrolled in the liver cirrhosis control group. The expression of α-fetoprotein （AFP） ,α-L-fucosidase （AFU） ,carcino-embryonic antigen （ CEA）, sugar chain antigen series （ CA12, CA153, CA199） and Golgi Membrane protein 73 （GP73） was used as a marker of serum tumor markers. AFP, CA series and CEA were detected by electrochemiluminescence method. GP73 and AFU were detected by enzyme color method. The serum markers were measured in 82 patients with suspected primary liver cancer,73 patients with liver cirrhosis and 80 healthy subjects in the same period and confirmed to be healthy in the absence of these diseases. Results The levels of AFP, AFU, CEA, CA125, CA199 and GP73 in liver cancer group were significantly different from those in normal control group （P 〈 0. 01 ）. The area under the curve （AUC） was （95% confidence interval） 0. 827,0. 787,0. 711,0. 791,0. 830,0. 812 and 0. 817,respectively,and the AUC of AFP and CA125 was the largest. The sensitivity of the single test was lower than that of the combined serum marker, and the sen- sitivity was significantly increased with the increase of the test species. The difference was statistically significant. Conclusion The combination of serum markers has a certain clinical value in the early diagnosis of liver cancer, but a variety of serum tumor markers to detect the sensitivity of the same time to reduce the specificity of a certain degree.

关 键 词：原发性早期肝癌 血清肿瘤标志物 甲胎蛋白 岩藻糖苷酶 癌胚抗原 糖链抗原 高尔基体膜蛋白73 

分 类 号：R735.7[医药卫生—肿瘤]