血AFP/CEA与HCY联合检测在诊断原发性肝细胞癌中的应用  

Application of serum AFP/CEA and HCY combined detection in the diagnosis of primary hepatic carcinoma

作　　者：余道武[1] 余天雾[1] 苟毅[1] 杨陆蒙[2] YU Daowu;YU Tianwu;GOU Yi;YANG Lumeng(Department of Hepatobiliary Surgery,Yongchuan Hospital Affiliated to Chongqing Medical University,Yongchuan,Chongqing,China,402160;Department of Vascular Surgery of Mammary Hernia,Yongchuan Hospital Affiliated to Chongqing Medical University,Yongchuan,Chongqing,China,402160)

机构地区：[1]重庆医科大学附属永川医院肝胆外科,重庆402160 [2]重庆医科大学附属永川医院乳甲疝血管外科,重庆402160

出　　处：《分子诊断与治疗杂志》2022年第4期552-555,共4页Journal of Molecular Diagnostics and Therapy

基　　金：永川区自然科学基金计划(Ycstc,2019nb0201)。

摘　　要：目的探讨血甲胎蛋白/癌胚抗原(AFP/CEA)与血浆同型半胱氨酸(HCY)联合检测在诊断肝细胞癌(HCC)中的应用价值。方法选取2016年6月到2018年9月在重庆医科大学附属永川医院收治的85例HCC患者作为HCC组,选取同期收治的100例非HCC患者为对照组。记录年龄、吸烟史、饮酒史、Child⁃Pugh分级等一般资料,采用ELISA法检测HCY水平,ROCHE化学发光仪检测患者血清AFP、CEA水平,多因素Logistic回归分析影响HCC发生的危险因素,ROC分析血AFP/CEA与HCY联合诊断HCC的诊断价值。结果HCC组存在饮酒史、吸烟史所占比例明显高于非HCC组,血HCY、AFP、CEA和AFP/CEA水平明显高于非HCC组,差异均有统计学意义(P<0.05)。Logistic分析结果显示,合并饮酒史、HCY升高、AFP升高、CEA升高和AFP/CEA比值升高均为影响HCC的独立危险因素(P<0.05)。ROC分析结果显示,AFP/CEA联合HCY诊断HCC的AUC为0.918,明显高于AFP/CEA或者HCY单独检测(P<0.05)。TNM分期为Ⅱ期组患者血清HCY、AFP和AFP/CEA水平明显高于Ⅰ期组,差异有统计学意义(P<0.05)。结论血AFP/CEA与HCY联合检测对HCC具有较高的诊断价值,临床可根据其水平变化预测HCC发生和进展。Objective To explore the application value of combined detection of serum alpha fetoprotein/carcino⁃embryonic antigen(AFP/CEA)and plasma homocysteine(HCY)in the diagnosis of hepatocellular carcinoma(HCC).Methods 85 patients confirmed with HCC admitted to Yongchuan Hospital Affiliated to Chongqing Medical University from June 2016 to September 2018 were selected as the HCC group.100 non⁃HCC patients who were admitted in same period were enrolled as the control group.The general data such as gender,age,smoking history,drinking history and Child⁃Pugh classification in both groups were recorded.HCY level was detected by ELISA.The serum AFP and CEA levels were detected by ROCHE chemiluminescence instrument.The multivariate Logistic regression analysis was performed to analyze risk factors influencing occurrence of HCC.ROC analysis was performed to analyze diagnostic value of serum AFP,CEA AFP/CEA combined with HCY for HCC.Results The proportion of drinking history and smoking history in the HCC group were significantly higher than that in the non⁃HCC group,and the blood levels of HCY,AFP,CEA and AFP/CEA were significantly higher than those in the non⁃HCC group,with statistical significance(P<0.05).Logistic analysis showed that drinking history,HCY increasing,AFP increasing,CEA increasing and AFP/CEA increasing were all independent risk factors influencing HCC(P<0.05).The results of ROC analysis showed that the AUC of serum AFP,CEA,AFP/CEA,HCY and AFP/CEA combined with HCY for diagnosis of HCC were 0.808,0.756,0.860,0.752 and 0.918,respectively.The AUC of AFP/CEA combined with HCY for diagnosis of HCC was significantly higher than that of AFP/CEA or HCY alone(P<0.05).The levels of HCY,AFP and AFP/CEA in TNM stageⅡgroup were significantly higher than those in TNM stageⅠgroup(P<0.05).Conclusion The combined detection of AFP/CEA and HCY has a high diagnostic value for HCC,and the occurrence and progression of HCC can be predicted clinically based on the changes of its levels.

关 键 词：甲胎蛋白 癌胚抗原 血浆同型半胱氨酸 肝细胞癌 

分 类 号：R735.7[医药卫生—肿瘤]