四种常见肿瘤标记物联合检测在肝胆系统良恶性疾病中的临床价值  

Clinical value of combined detection of four common tumor markers in benign and malignant hepatobiliary system diseases

作　　者：周常富 纪金星 

机构地区：[1]上饶市广丰区皮肤病性病防治所消化内科,江西省上饶市334600

出　　处：《世界华人消化杂志》2017年第35期3161-3166,共6页World Chinese Journal of Digestology

摘　　要：目的探讨四种常见肿瘤标记物在肝胆系统良恶性疾病中的临床价值.方法选取2015-02/2017-02在上饶市广丰区皮肤病性病防治所诊治的270例肝胆系统良恶性疾病(肝内胆管结石、肝脓肿、胆总管结石、胆囊炎、原发性肝细胞性肝癌、肝胆管细胞癌等)患者作为研究对象.应用酶联免疫法检测所有患者入院时甲胎蛋白(α-fetoprotein,AFP)、癌胚抗原(carcino-embryonic antigen,CEA)、糖链抗原19-9(carbohydrate antigen,CA19-9)和癌抗原125(cancer antigen 125,CA125)的水平,并分析其在疾病中的诊断及疗效监测价值.结果健康正常对照组与肝胆良性疾病组各肿瘤标志物差异无统计学意义(P>0.05);肝胆恶性疾病组各肿瘤标志物均明显高于肝脏良性疾病组,且差异具有统计学意义(P<0.05).在肝脏恶性疾病中:AFP的单项检测的灵敏度、特异度及正确率均居首位;与单项检测比较,联合检测的灵敏度明显升高(P<0.05),但特异度及正确率相对降低(P>0.05).在胆道恶性疾病中,CA19-9单项检测的灵敏度、特异度及正确率均居首位;与单项检测比较,联合检测的灵敏度明显升高(P<0.05),但特异度及正确率相对降低(P>0.05).与治疗前比较,治疗后肝胆恶性疾病患者的AFP、CEA、CA19-9及CA125明显下降,且差异具有统计学意义(P<0.05).结论与单项检测比较,肿瘤标记物联合检测可明显提高肝胆系统良恶性疾病的诊断及疗效监测价值.AIM To assess the clinical value of combined detection of four common tumor markers in benign and malignant hepatobiliary system diseases.METHODS Two hundred and seventy patients with benign and malignant hepatobiliary system diseases（hepatolithiasis, liver abscess, choledocholithiasis, cholecystitis, primary hepatocellular carcinoma, and cholangiocarcinoma） treated at our hospital from February 2015 to February 2017 were included. The levels of α-fetoprotein（AFP）, carcino-embryonic antigen（CEA）, carbohydrate antigen19-9（CA19-9）, and cancer antigen 125（CA125） were detected in all patients by enzyme linked immunosorbent assay, and their value in disease diagnosis and curative effect monitoring was assessed.RESULTS There was no significant difference in serum levels of tumor markers between the normal control group and the benign liver disease group（P〈0.05）. The levels of tumor markers in the malignant hepatobiliary disease group were significantly higher than those in the benign liver disease group（P〈0.05）. In malignant liver diseases, the sensitivity, specificity, and accuracy of AFP were the highest among all single detections; compared with single detection, the sensitivity of combined detection was increased significantly（P〈0.05）, but the specificity and accuracy were decreased（P〈0.05）. In malignant biliary diseases, the sensitivity, specificity, and accuracy of CA19-9 were the highest among all single detections; compared with single detection, the sensitivity of combined detection was increased significantly（P〈0.05）, but the specificity and accuracy were decreased（P〈0.05）. Compared with the values before treatment, the levels of AFP, CEA, CA19-9, and CA125 in patients with malignant hepatobiliary diseases significantly decreased after treatment（P〈0.05）.CONCLUSION Compared with single detection, the combined detection of tumor markers can significantly improve the value of diagnosis and curative effect monitoring in benign and malignant diseases o

关 键 词：肝胆系统良恶性疾病 肿瘤标记物 诊断 疗效监测 

分 类 号：R575[医药卫生—消化系统] R735[医药卫生—内科学]