甲胎蛋白和癌胚抗原在肿瘤肝癌临床检测中的应用(1)
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【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AFP>20 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AFP>400 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<0.01)。结论 AFP升高对 HCC诊断具有较强的提示作用,结合CEA值的升高用于高危人群筛查及对于AFP阳性患者术后随访具有重要作用。
【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<0.01).Conclusion AEP increase on strong HCC diagnosed with hints of function,increase the CEA value for high-risk patients with positie screening for AFP and plays on important role in the follow-up.
【Key words】AFP;CEA;PHC;Predictive diagnostics
中国是世界第一肝癌大国,每年的新发病例有20万。据2008年CSCO学术年会统计,原发性与继发性肝癌为世界第三大癌症,而在中国肝癌仅次于肺癌,为中国第二大癌症[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 ......
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