甲胎蛋白和癌胚抗原在肿瘤肝癌临床检测中应用.docVIP

甲胎蛋白和癌胚抗原在肿瘤肝癌临床检测中应用 　　【摘要】 目的 评价血清甲胎蛋白(AFP)及癌胎抗原(CEA)在原发性肝癌(PHC)临床诊断中的应用及其价值。方法 对201例原发性肝癌(PHC),73例肝硬化和54例健康对照者,用微粒子化学发光免疫分析法测定血清AFP和 CEA。结果 PHC患者的AEP水平显著高于肝硬化的患者及健康体检者。肝硬化组的AEP也有一定程度的升高。原发性肝癌 AFP极度增高,可达到6027 μg/L肝硬化患者的血清AFP亦有一定程度的提高,可达到1880 μg/L。当肝病患者以AFP20 μg/L作为阈值诊断原发性肝癌时,其灵敏度为73.13%,特异性达38.36%,以AFP400 μg/L作为阈值诊断原发性肝癌时,其灵敏度为44.28%,特异性达80.43%。CEA以PHC组最高,为(13.4±32.6)μg/L,明显比肝硬化和健康对照组高(P 　　【关键词】甲胎蛋白;癌胚抗原;原发性肝癌;预测诊断 　　Armor embryo protein and cancer embryo antigen in tumor liver cancer clinical examination application 　　DONG Xi-huan.The First People’s Hospital of Shangqiu,Henan 476100,China 　　【Abstract】 Objective To evaluate the usefulness of serum alpha-fetoprotein(AFP)and carcinoemb-ryonic antigen(CEA)carcinoma in clinical diagnosis and screening for primary hepatic carcinoma(PHC).Methods Totally 201 PHC patients,73 liver cirrhosis patients,and 54 healthy subjects were enrolled in this study.All of the sample were measured by microparticle chemiluminescent immunoassay.Results The serum AFP level was significantly higher in PHC patients than in liver cirrhosis patients and healthy subjects.The serum AFP level was increase in liver cirrhosis patients too.The serum AFP level was extremely increased in PHC patients,it could be up to 6027 μg/L,and it also increased in liver cirrhosis patients,it could be up to 1880 μg/L.Sensitivity and specificity ofAFP at 20 μg/L cut-off was 73.13%and 38.36%.Sensitivity and specificity ofAFP at 400 μg/L cut-off was only 44.28%and 80.43%.The serum CEA level was(13.4±32.6)μg/L,which was significantly higher than the other two group(P[1]。甲胎蛋白(alpha-fetoprotein,AFP)是目前临床惟一广泛使用的原发性肝癌(hepatocellular carcinoma,PHC)诊断血清标记物,临床上使用AFP用于肝癌高危人群的普查和筛查可使部分患者的术后生存期和预后有了显著的提高。癌胚抗原(carcino-embry-onic antigen related cellular adhesi on molecule 1,CEA)是一种细胞表面跨膜糖蛋白,也是癌胚抗原家族的一个成员,属于免疫球蛋白超家族黏附分子[2]。研究表明,结肠癌、胃癌、胰腺癌、子宫癌等患者血清CEA均呈现不同程度的升高[3,4]虽然在临床上对CEA应用的研究不多,但是其潜在优势值得广泛的关注。本研究对比AFP和CEA的检测结果,对不同人群在临床上对癌肿与其他肝脏疾病的鉴别诊断进行分析,探讨其对各类肝病的鉴别诊断价值。探讨CEA与原发性肝癌之间的关系,