AFP及CEA及CA199联合检测对原发性肝癌诊断价值.docVIP

AFP及CEA及CA199联合检测对原发性肝癌诊断价值 　【摘要】 目的：探讨血清甲胎蛋白(AFP)、癌胚抗原199(CEA)与肿瘤抗原(CA199)联合检测对原发性肝癌的早期诊断价值。方法：应用电化学发光法联合测定51例原发性肝癌和75例良性肝病（肝硬化、慢性肝炎）患者血清AFP、CEA与CA199的水平。结果：肝癌组血清AFP、CEA和CA199阳性率分别为74.5％、49.0％和45.1％，显著高于良性肝病组(Plt;0.05)；三项联合对肝癌阳性率提高至９2.2％、与单项检测相比均有明显差异。结论：3项肿瘤标志物对肝肿瘤的良恶性辅助诊断及鉴别诊断具有一定应用价值，联合检测可以提高原发性肝癌的阳性诊断率。 【关键词】 原发性肝癌；AFP；CEA；CA199 　　Clinical Value of Combined Detection of AFP, CEA and CA199 in the Diagnosis of Primary Liver Cancer 　　ZHANG Ting, LUO Liang, WANG Ni 　　1.The Second Affiliated Hospital of Medical College of Xian Jiaotong University, Xi’an, Shaanxi 710004, China； 　　2.The Second Peoples Hospital of Wuxi, Wuxi, Jiangsu 214000, China Abstract: Objective To study the clinical value of combined detection of the serum levels of AFP, CEA and CA199 in the early diagnosis of primary liver cancer. Methods The serum levels of AFP, CEA and CA199 in 51 patients with primary hepatic carcinoma, 75 patients with benign liver disease （hepatic cirrhosis, chronic hepatitis）were measured by Electrochemiluminescence. Results Sensitivities of AFP, CEA and CA199 in primary liver cancer group were 74.5％,49.0％ and 45.1％,respectively. They were significantly higher than those in benign liver disease (Plt;0.05). Sensitivity of combined detection of three kinds of tumor markers was 92.2%. It was significantly higher than that of single one. Conclusion The detection of AFP, CEA and CA199 are helpful in diagnosis and in differential diagnosis of primary hepatic carcinoma. Combined detection of the three tumor markers increases the detective positive rate. Key words: Primary Hepatic Carcinoma; AFP; CEA; CA199 原发性肝癌(Primary Hepatic Carcinoma, PHC)是当前全球最为常见的10种恶性肿瘤之一，其发病率自20世纪90年代起已经居于我国癌症的第2位，并呈逐年增高趋势。PHC的诊断主要依赖B超、CT、MRI、血管造影等。早期病变影像技术很难发现，也难以确定肿块的性质。迄今为止，肿瘤标志物虽已达数百种，AFP用于PHC人群筛检也已广泛开展，但是其特异性及灵敏度仍然不够理想［1］。因此，本文拟采用电化学发光免疫分析技术联合检测甲胎蛋白(AFP)、癌胚抗原(CEA)与肿瘤抗原199（CA199），以期为临床早期诊断PHC提供更为合理的检测方案。 　　1 对象与方法 　　1.1 研究对象 　　PHC组患者51例，男30例，女21例，年龄31岁~80岁，平均年龄49.7岁。所有病例均系2005年至2006年西安交通大学医学院第二医院门