癌胚抗原、组织多肽抗原、糖类抗原19-9、维生素K缺乏或拮抗剂-Ⅱ诱导蛋白、甲胎蛋白联合检测对原发性肝癌的诊断价值  

Diagnostic value of carcinoembryonic antigen,tissue peptide antigen,carbohydrate antigen 19-9,protein induced by vitamin K absence or,antagonist-II,and alpha fetoprotein for primary liver cancer

作　　者：张琳倩 彭艳芝 王佳宁 宁文君 ZHANG Linqian;PENG Yanzhi;WANG Jianing;NING Wenjun(Department of Laboratory Medicine,Xi’an Daxing Hospital,Xi’an 710016,Shaanxi,China)

机构地区：[1]西安大兴医院检验科,西安710016

出　　处：《癌症进展》2023年第14期1602-1605,共4页Oncology Progress

摘　　要：目的 探讨血清癌胚抗原(CEA)、组织多肽抗原(TPA)、糖类抗原19-9(CA19-9)、维生素K缺乏或拮抗剂-Ⅱ诱导蛋白(PIVKA-Ⅱ)、甲胎蛋白(AFP)联合检测对原发性肝癌的诊断价值。方法 选取83例疑似原发性肝癌患者,以手术病理结果作为金标准,分析血清CEA、TPA、CA19-9、PIVKA-Ⅱ、AFP单独及联合检测对原发性肝癌的诊断效能,比较不同临床分期原发性肝癌患者的血清CEA、TPA、CA19-9、PIVKA-Ⅱ、AFP水平,采用Pearson相关分析法分析血清CEA、TPA、CA19-9、PIVKA-Ⅱ、AFP水平与原发性肝癌患者临床分期的相关性。结果 血清CEA、TPA、CA19-9、PIVKA-Ⅱ、AFP联合检测诊断原发性肝癌的灵敏度、特异度、准确度及约登指数分别为95.95%、88.89%、95.18%、0.85,均高于各指标单独检测。不同临床分期原发性肝癌患者的血清CEA、TPA、CA19-9、PIVKA-Ⅱ、AFP水平比较,差异均有统计学意义(P﹤0.01);随着临床分期的升高,原发性肝癌患者的血清CEA、TPA、CA19-9、PIVKA-Ⅱ、AFP水平均逐渐升高。相关性分析结果显示,血清CEA、TPA、CA19-9、PIVKA-Ⅱ、AFP水平与原发性肝癌患者的临床分期均呈正相关(P﹤0.05)。结论 血清CEA、TPA、CA19-9、PIVKA-Ⅱ、AFP可作为临床诊断原发性肝癌和监测病情进展的客观实验室指标,单独检测的诊断效能一般,联合检测可提高诊断效能,更有利于原发性肝癌的早期检出。Objective To investigate the diagnostic value of serum carcinoembryonic antigen(CEA),tissue peptide antigen(TPA),carbohydrate antigen 19-9(CA19-9),protein induced by vitamin K absence or antagonist-II(PIVKA-II),and alpha fetoprotein(AFP)for primary liver cancer.Method A total of 83 patients with suspected primary liver were selected.The diagnostic efficacy of single and combined detection of CEA,TPA,CA19-9,PIVKA-II,and AFP for prima-ry liver cancer were analyzed using surgical pathology results as the gold standard,and the serum levels of CEA,TPA,CA19-9,PIVKA-II,and AFP in primary liver cancer patients with different clinical stages were compared.The correla-tion of serum CEA,TPA,CA19-9,PIVKA-II,and AFP levels with clinical stages of primary liver cancer patients were an-alyzed by using the Pearson correlation analysis.Result The sensitivity,specificity,accuracy and Youden index of com-bined detection of serum CEA,TPA,CA19-9,PIVKA-II and AFP in the diagnosis of primary liver cancer were 95.95%,88.89%,95.18%and 0.85,respectively,which were higher than single detection.There were significant differences in se-rum CEA,TPA,CA19-9,PIVKA-II and AFP levels in primary liver cancer patients with different clinical stages(P<0.01);with the increase of clinical stage,the serum CEA,TPA,CA19-9,PIVKA-II and AFP levels in patients with prima-ry liver cancer were gradually increased.Correlation analysis showed that serum CEA,TPA,CA19-9,PIVKA-II and AFP levels were positively correlated with the clinical stage of patients with primary liver cancer(P<0.05).Conclusion Se-rum CEA,TPA,CA19-9,PIVKA-II and AFP can be used as objective laboratory indicators for clinical diagnosis of prima-ry liver cancer and monitoring of disease progression.The diagnostic efficacy of single detection is average,while com-bined detection can improve the diagnostic efficacy and be more conducive to the early detection of primary liver cancer.

关 键 词：癌胚抗原 组织多肽抗原 糖类抗原19-9 维生素K缺乏或拮抗剂-Ⅱ诱导蛋白 甲胎蛋白 原发性肝癌 

分 类 号：R735.7[医药卫生—肿瘤]