摘要
目的探讨联合检测甲胎蛋白(AFP)和癌胚抗原(CEA)对原发性肝癌与转移性肝癌及肝良性肿瘤的鉴别诊断价值。方法对62例原发性肝癌、41例转移性肝癌、32例肝良性肿瘤和50例健康对照者,用电化学发光免疫分析法测定血清AFP和CEA浓度。结果原发性肝癌患者血清AFP为(3861.6±5436.8)μg/L,明显比转移性肝癌〔(28.3±75.4)μg/L〕和肝良性肿瘤〔(4.6±2.2)μg/L〕及健康对照组〔(4.5±2.3)μg/L〕高(F=30.36,P<0.01)。而CEA却以转移性肝癌组最高,达(81.5±157.3)μg/L,原发性肝癌组其次,为(14.2±35.7)μg/L,肝良性肿瘤组和健康对照组最低,分别为(3.1±2.4)μg/L和(2.7±1.8)μg/L。以AFP>400μg/L作为原发性肝癌的诊断界值,则AFP对原发性肝癌的诊断灵敏度为75.81%,特异性为98.63%,阳性预报值为97.92%,阴性预报值为82.76%,诊断准确度为88.15%。结论AFP和CEA联合检测能更好地诊断和鉴别诊断原发性肝癌与转移性肝癌及肝良性肿瘤。
Objective To study the diagnostic value in distinguishing primary hepatic carcinoma from metastatic hepatic carcinoma as well as benign tumor of liver by combined detection of alpha fetoprotein（AFP） and carcinoembryonic antigen（CEA）. Methods The levels of AFP and CEA were measured in 62 patients with primary hepatic carcinoma, 41 patients with metastatic hepatic carcinoma,32 patients with benign tumor of liver and 50 healthy subjects by electro chemiluminescence immunoassay method. Results The patients with primary hepatic carcinoma had significantly higher level of AFP compared with metastatic hepatic carcinoma,benign tumor of liver and controls（P〈0.01）. The concentrations of AFP were（3861.6±5436. 8） μg/L for primary hepatic carcinoma,（28.3±75.4） μg/L for metastatic hepatic carcinoma,（4.6±2.2） μg/L for benign tumor of liver and（4.5±2.3） μg/L for controls,respectively. However, the serum concentration of CEA in the patients with metastatic hepatic carcinoma was the highest（81.5±157.3 μg/L）,the primary hepatic carcinoma group was secondary（14.2±35.7 μg/L）,and the groups of benign tumor of liver and healthy subjects had lowest levels of CEA（3.1±2.4 μg/L vs 2.7±1.8 μg/L）. The diagnostic efficiency for primary hepatic carcinoma was 75.81% for sensitivity,98.63 % for specificity,97.92 % for positive predictive value, 82.76 % for negative predictive value and 88.15% for accuracy, respectively, when boundary value of AFP was more than 400μg/L. Conclusion Combined determination of tumor markers of AFP and CEA can provide better diagnostic efficiency in distinguishing primary hepatc carcinoma from metastatic hepatic carcinoma as well as benign tumor of liver.
出处
《重庆医学》
CAS
CSCD
2008年第12期1333-1335,共3页
Chongqing medicine
关键词
甲胎蛋白
癌胚抗原
原发性肝癌
转移性肝癌
肝良性肿瘤
alpha fetoprotein
carcinoembryonic antigen
primary hepatic carcinoma
metastatic hepatic carcinoma
benign tumor of liver
