肿瘤标记物对原发性及继发性肝癌患者的诊疗价值
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摘要
目的探讨肿瘤标记物对原发性及继发性肝癌患者的诊疗价值。方法随机选取肝脏良性肿瘤、原发性及继发性肝癌、肝内结石、化脓性胆管炎、胆总管结石治疗的患者共542例,根据临床诊断病情的良恶性共分为三组,即良性肿瘤组182例、恶性肿瘤组251例和正常组109例。对患者年龄、性别、病史、肿瘤标记物(常见四种为甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)和糖类抗原125(CA-125))、乙肝病史情况等数据进行记录。采用抗原抗体结合法和生物测光仪测光法检测所有研究对象血液样本肿瘤标记物值。结果良性肿瘤组和原发性及继发性肝癌组AFP、CEA、CA19-9和CA-125检测值均明显高于炎性病变组的,差异具有统计学意义(P <0. 05);实验发现联合多种肿瘤标记物(AFP、CEA、CA19-9和CA-125)检测有效的提高了检测的敏感度,四种肿瘤标记物(AFP、CEA、CA19-9和CA-125)联合检测良性肿瘤组的敏感度达61. 1%,特异性为25. 6%,恶性肿瘤组的敏感度达64. 5%,特异性为80. 0%,正常组的敏感度达40. 9%,特异性为18. 6%; 542例患者中有乙肝217例,无乙肝325例,有乙肝患者的AFP检测平均值为(400±100. 1) U/ml,无乙肝的为(342. 6±154. 9) U/ml,CEA、CA19-9和CA-125的检测平均值在两组间差异明显,具有统计学意义(P <0. 05)。结论临床检测原发性及继发性肝癌要结合多种肿瘤标记物,可提高检测准确率,同时要将患者有无乙肝病史情况加以考虑,进一步提高检测准确率。
Objective Clinical value of tumor markers in patients with primary and secondary liver cancer. Methods A total of 542 patients with benign liver tumors,primary and secondary liver cancer,hepatolithiasis,suppurative cholangitis,and common bile duct stones were randomly selected,According to the clinical diagnosis,the patients were divided into three groups,182 cases of benign tumor group,251 cases of malignant tumors and 109 cases of normal group. On the age of patients,gender,medical history,tumor markers( four common for alpha fetoprotein( AFP),carcinoembryonic antigen( CEA),carbohydrate antigen 19-9( CA19-9) and carbohydrate antigen 125( CA-125),the history of hepatitis B and other data were recorded. Tumor markers in blood samples of all subjects were examined by antigen antibody binding and biological photometry. Results The major experimental indexes of benign and malignant tumor and inflammatory lesion were the values of AFP,CEA,CA19-9 and CA-125,AFP,CEA,CA19-9 in benign tumor group and malignant tumor group And CA-125 were significantly higher than those in the inflammatory lesion group( P < 0. 05). The results showed that the combination of various tumor markers( AFP,CEA,CA19-9 and CA-125)( AFP,CEA,CA19-9 and CA-125) were significantly higher than those in the control group( P < 0. 05). The sensitivity of the four tumor markers( AFP,CEA,CA19-9 and CA-125) was 61. 1%,the specificity was 25. 6%,the sensitivity of the malignant tumor group 64% of the specificity of 80. 0%,the sensitivity of the normal group of 40. 9%,specificity of 18. 6%; 542 cases of patients with HBV in 217 cases,no hepatitis B 325 cases,hepatitis B patients with AFP detection of the average( 400( 342. 6 ± 154. 9) U/ml,the mean values of CEA,CA19-9 and CA-125 were significantly different between the two groups( P <0. 05). Conclusion Clinical detection of primary and secondary liver cancer should be combined with a variety of tumor markers,can improve the accuracy of detection,while patients with hepatitis B history should be taken into account,to further improve the accuracy of detection.
Objective Clinical value of tumor markers in patients with primary and secondary liver cancer. Methods A total of 542 patients with benign liver tumors,primary and secondary liver cancer,hepatolithiasis,suppurative cholangitis,and common bile duct stones were randomly selected,According to the clinical diagnosis,the patients were divided into three groups,182 cases of benign tumor group,251 cases of malignant tumors and 109 cases of normal group. On the age of patients,gender,medical history,tumor markers( four common for alpha fetoprotein( AFP),carcinoembryonic antigen( CEA),carbohydrate antigen 19-9( CA19-9) and carbohydrate antigen 125( CA-125),the history of hepatitis B and other data were recorded. Tumor markers in blood samples of all subjects were examined by antigen antibody binding and biological photometry. Results The major experimental indexes of benign and malignant tumor and inflammatory lesion were the values of AFP,CEA,CA19-9 and CA-125,AFP,CEA,CA19-9 in benign tumor group and malignant tumor group And CA-125 were significantly higher than those in the inflammatory lesion group( P < 0. 05). The results showed that the combination of various tumor markers( AFP,CEA,CA19-9 and CA-125)( AFP,CEA,CA19-9 and CA-125) were significantly higher than those in the control group( P < 0. 05). The sensitivity of the four tumor markers( AFP,CEA,CA19-9 and CA-125) was 61. 1%,the specificity was 25. 6%,the sensitivity of the malignant tumor group 64% of the specificity of 80. 0%,the sensitivity of the normal group of 40. 9%,specificity of 18. 6%; 542 cases of patients with HBV in 217 cases,no hepatitis B 325 cases,hepatitis B patients with AFP detection of the average( 400( 342. 6 ± 154. 9) U/ml,the mean values of CEA,CA19-9 and CA-125 were significantly different between the two groups( P <0. 05). Conclusion Clinical detection of primary and secondary liver cancer should be combined with a variety of tumor markers,can improve the accuracy of detection,while patients with hepatitis B history should be taken into account,to further improve the accuracy of detection.
引文
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[12]Yu T,Yu H,Cai X.Preoperative prediction of survival in resectable gallbladder cancer by a combined utilization of CA 19-9 and carcinoembryonic antigen[J].Chinese Med J2014,127(12):2299-2303.
[13]Shultz DB,Chan C,Shaffer JL,et al.Postradiotherapy CA1-9-9 kinetics correlate with outcomes in patients with pancreatic adenocarcinoma[J].Pancreas,2014,43(5):777-783.
[14]Huang YH,Zhu C,Kondo Y,et al.CEACAM1 regulates T-IM-3-mediated tolerance and exhaustion[J].Nature,2015,517(7534):386-390.
[15]Sun W,Liu Y,Shou D,et al.AFP(alpha fetoprotein):Who are you in gastrology?[J].Cancer Lett,2015,357(1):43-46.
[2]Lim TS,Kim DY,Han KH,et al.Combined use of AFP,PIVKA-II,and AFP-L3 as tumor markers enhances diagnostic accuracy for hepatocellular carcinoma in cirrhotic patients.[J].Scandinavian J Gastroenterol,2016,51(3):344-353.
[3]Xu WJ,Guo BL,Han YG,et al.Diagnostic value of alphafetoprotein-L3 and Golgi protein 73 in hepatocellular carcinomas with low AFP levels[J].Tumor Biol,2014,35(12):12069-12074.
[4]程群英,邹春标.联合检测血清肿瘤标记物在恶性肿瘤诊断中的价值[J].现代预防医学,2015,42(22):4221-4224.
[5]Wilbaux M,Hénin E,Oza A,et al.Prediction of tumour response induced by chemotherapy using modelling of CA-125kinetics in recurrent ovarian cancer patients[J].Brit JCancer,2014,110(6):1517-1524.
[6]Killock D.Gynaecological cancer:Biomarker potential of C-A-125 enhanced[J].Nature Rev Clin Oncol,2015,12(8):255-264.
[7]李汛,严俊,孟文勃,等.血清CA19-9在胆道系统良恶性疾病鉴别诊断中的临床价值[J].中华肝脏外科手术学电子杂志,2014,15(4):26-30.
[8]Thibaut T,BlanfunéA,Markovic L,et al.Unexpected abundance and long-term relative stability of the brown alga Cystoseira amentacea,hitherto regarded as a threatened species,in the north-western Mediterranean Sea[J].Marine Pollut Bullet,2014,89(1):305-323.
[9]Lang CB,Petreczky P.U(1)gauge theory with Villain action on spherical lattices[J].Physics Lett B,2016,387(3):558-562.
[10]Kuwatsuru R,Horikoshi K,Akamatsu M,et al.Noninvasive3D MR angiography in patients with biliary atresia:morphological assessment of the portal venous system as an indicator for liver transplantation[J].Pediat Radiol,2014,30(10):721-722.
[11]崔恒,李艺,昌晓红.再谈正确认识和应用肿瘤标记物[J].中国妇产科临床杂志,2014,12(5):385-387.
[12]Yu T,Yu H,Cai X.Preoperative prediction of survival in resectable gallbladder cancer by a combined utilization of CA 19-9 and carcinoembryonic antigen[J].Chinese Med J2014,127(12):2299-2303.
[13]Shultz DB,Chan C,Shaffer JL,et al.Postradiotherapy CA1-9-9 kinetics correlate with outcomes in patients with pancreatic adenocarcinoma[J].Pancreas,2014,43(5):777-783.
[14]Huang YH,Zhu C,Kondo Y,et al.CEACAM1 regulates T-IM-3-mediated tolerance and exhaustion[J].Nature,2015,517(7534):386-390.
[15]Sun W,Liu Y,Shou D,et al.AFP(alpha fetoprotein):Who are you in gastrology?[J].Cancer Lett,2015,357(1):43-46.