血清肿瘤标志物联合血常规检测在原发性肝癌中的诊断价值  

Significance of serum tumor marker combined with blood routine tests in the diagnosis of primary liver cancer

作　　者：王海东 李宁侠 董恒利[1] 赵会荣 李瑛 牟花妮 WANG Hai-dong;LI Ning-xia;DONG Heng-li;ZHAO Hui-rong;LI Ying;MOU Hua-ni(Inpatient Laboratory,The Second Affiliated Hospital of Xi'an Medical University,Xi'an 710038,China;Department of Gastroenterology,The Second Affiliated Hospital of Xi'an Medical University,Xi'an 710038,China)

机构地区：[1]西安医学院第二附属医院住院检验科,西安710038 [2]西安医学院第二附属医院消化内科,西安710038

出　　处：《中国肿瘤临床与康复》2022年第5期541-543,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨血清肿瘤标志物联合血常规检测在原发性肝癌诊断中的应用价值。方法选取2019年1月至2020年12月间西安医学院第二附属医院收治的72例原发性肝癌患者为研究组,同期选取72例慢性乙肝患者为对照组,检测两组患者及研究组中不同肿瘤直径患者的血清肿瘤标志物与血常规指标,血清肿瘤标志物和血常规指标单独及联合检测的效果比较。结果研究组患者中性粒细胞淋巴细胞比值(NLR)、白细胞、糖类抗原19-9(CA19-9)及甲胎蛋白(AFP)水平均较对照组高,差异均有统计学意义(均P<0.05)。研究组中,肿瘤直径≥5cm患者的NLR、白细胞、CA19-9及AFP水平均高于<5cm者,差异均有统计学意义(均P<0.05)。研究组患者血清肿瘤标志物+血常规指标检测阳性率97.2%(70例),血清肿瘤标志物检测阳性率73.6%(53例),血常规指标检测阳性率84.7%(61例)。血清肿瘤标志物和血常规指标联合检测的敏感度、特异度、阳性预测值及阴性预测值均高于二者单独检测(均P<0.05)。结论原发性肝癌患者的血清肿瘤标志物与血常规指标均较高,血清肿瘤标志物与血常规联合检测的阳性率、敏感度、特异度、阳性预测值及阴性预测值均较高,值得临床研究与借鉴。Objective To systematically analyze the value of serum tumor marker combined with blood routine tests in the diagnosis of primary liver cancer.Methods Seventy-two patients with primary liver cancer were selected and included in an experimental group from January 2019 to December 2020,and 72 patients with chronic hepatitis B were selected and included in a control group during the same period.The serum levels tumor markers and routine blood indices were detected in the two groups.The efficacy of single detection of serum tumor markers or blood routine tests were compared with the dual detection of these two for the diagnosis of primary liver cancer.Results Compared with the control group,neutrophil to lymphocyte ratio(NLR),leukocyte,carbohydrate antigen 19-9(CA19-9)and alpha-fetoprotein(AFP)levels were higher in the experimental group(all P<0.05).NLR,leukocyte,CA19-9 and AFP levels were higher in patients with tumor diameter≥5 cm than in patients with tumor diameter<5 cm in the experimental group(all P<0.05).The positive rate was 97.2%(70 patients),73.6%(53 patients)and 73.6%(53 patients),respectively for the detection of serum tumor markers plus blood routine tests,single detection of serum tumor markers and single blood routine tests.The sensitivity,specificity,positive predictive value and negative predictive value were higher for serum tumor markers detection plus blood routine tests than single serum tumor marker detection or blood routine tests.Conclusion The serum tumor markers and blood routine tests are high in patients with primary liver cancer,and the combined detection shows high positive rate,sensitivity,specificity,positive predictive value and negative predictive value,which is worthy of clinical research and reference.

关 键 词：血清肿瘤标志物 血常规指标 原发性肝肿瘤 诊断 

分 类 号：R735.7[医药卫生—肿瘤]