血清糖类抗原125糖类抗原199甲胎蛋白癌胚抗原水平测定在肝硬化患者临床分析中的应用价值
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摘要
目的探讨血清糖类抗原125(CA125)、糖类抗原199(CA199)、甲胎蛋白(AFP)和癌胚抗原(CEA在肝硬化患者病情评估和判断预后中的检测意义。方法分析2015年6月至2017年8月在我院消化内科就诊的85例肝硬化患者的临床资料(包括4种肿瘤标志物的血清测定值、Child-Pugh分级和合并腹腔积液与否等情况),另外以同期在我院体检的52名健康人作为对照组。比较肝硬化组与对照组间、不同Child-Pugh分级间、合并腹腔积液组与无腹腔积液组间4种肿瘤标志物的血清水平,并采用SPSS 23.0软件对相关数据进行分析。结果肝硬化患者血清CA125、CA199、AFP和CEA水平高于健康人群;不同Child-Pugh分级间4种肿瘤标志物的血清水平差异有统计学意义,且随分级的增加而升高,并与分级呈正相关;合并腹腔积液的患者4种肿瘤标志物的血清水平高于无腹腔积液的患者。除了多数肝硬化患者血清CA125水平高于正常参考区间上限外,其他3种肿瘤标志物血清水平仅有少部分患者高于正常参考区间上限或只比健康人群相对增高且在正常参考区间范围内。结论动态监测肝硬化患者血清CA125、CA199、AFP和CEA水平的意义不在于诊断肝硬化疾病,而在于更好地评估肝功能受损情况、预测腹腔积液的发生、判断患者病情进展及预后等情况。
Objective To explore the significance of serum carbohydrate antigen(CA)125,CA199,alphafetoprotein(AFP)and carcinoembryonic antigen(CEA) in the evaluation and prognosis of patients with liver cirrhosis.Methods The clinical data of 85 patients with liver cirrhosis who were admitted to the department of digestive medicine of our hospital from June 2015 to August 2017 were analyzed(including serum test values of four tumor markers,childpugh classification,combined with or without ascites,etc.). In addition,52 healthy persons who were examined in our hospital at the same time were taken as the control group. Serum levels of four tumor markers were compared between the cirrhosis group and the control group,between different child-pugh classifications,and between the ascites group and the non-ascites group. SPSS 23.0 software was used to analyze the relevant data. Results Serum CA125,CA199,AFP and CEA levels of liver cirrhosis patients were significantly higher than those of healthy people. Serum levels of the four tumor markers were significantly different between child-pugh grades,and increased with the increase of the grades,and were positively correlated with the grades. Serum levels of four tumor markers in patients with ascites were significantly higher than those without ascites. Except that the serum CA125 level of most patients with cirrhosis was higher than the upper limit of the normal reference interval,only a small number of patients with other three tumor markers in serum levels were higher than the upper limit of the normal reference interval or only relatively higher than the healthy population and within the normal reference interval. Conclusion The significance of dynamic monitoring of serum CA125,CA199,AFP and CEA levels in liver cirrhosis patients is not to diagnose cirrhosis diseases,but to better assess the liver function damage,predict the occurrence of ascites,and judge the progress and prognosis of patients.
Objective To explore the significance of serum carbohydrate antigen(CA)125,CA199,alphafetoprotein(AFP)and carcinoembryonic antigen(CEA) in the evaluation and prognosis of patients with liver cirrhosis.Methods The clinical data of 85 patients with liver cirrhosis who were admitted to the department of digestive medicine of our hospital from June 2015 to August 2017 were analyzed(including serum test values of four tumor markers,childpugh classification,combined with or without ascites,etc.). In addition,52 healthy persons who were examined in our hospital at the same time were taken as the control group. Serum levels of four tumor markers were compared between the cirrhosis group and the control group,between different child-pugh classifications,and between the ascites group and the non-ascites group. SPSS 23.0 software was used to analyze the relevant data. Results Serum CA125,CA199,AFP and CEA levels of liver cirrhosis patients were significantly higher than those of healthy people. Serum levels of the four tumor markers were significantly different between child-pugh grades,and increased with the increase of the grades,and were positively correlated with the grades. Serum levels of four tumor markers in patients with ascites were significantly higher than those without ascites. Except that the serum CA125 level of most patients with cirrhosis was higher than the upper limit of the normal reference interval,only a small number of patients with other three tumor markers in serum levels were higher than the upper limit of the normal reference interval or only relatively higher than the healthy population and within the normal reference interval. Conclusion The significance of dynamic monitoring of serum CA125,CA199,AFP and CEA levels in liver cirrhosis patients is not to diagnose cirrhosis diseases,but to better assess the liver function damage,predict the occurrence of ascites,and judge the progress and prognosis of patients.
引文
[1]葛均波,徐永健.内科学[M]. 8版.北京:人民卫生出版社,2013:419-425.
[2] Oliveira MS,Silva RPM,Valle SDCND,et al. Chronic hepatitisB and D:prognosis according to Child-Pugh score[J]. Rev BrasEnferm,2017,70(5):1048-1053.
[3]代伟伟,刘正新,徐宝宏.肝硬化和肝癌患者血清CA125、CA199、AFP和CEA水平变化[J].实用肝脏病杂志,2017,20(1):81-84.
[4]黄喜岷,邱建国,洪睿珂.肝硬化患者血清CA125水平与Child-Pugh分级、CHE及腹水量相关性分析[J].肝胆胰外科杂志,2016,28(1):13-16.
[5]吴,李兆勇.肝硬化患者中血清CA125检测的临床意义[J].吉林医学,2018,39(5):956-958.
[6]孙成都,孙刚,郭明洲,等.血清CA125在肝硬化患者中的临床意义及相关因素研究[J].胃肠病学和肝病学杂志,2014,23(5):501-505.
[7]何淑妃,利旭辉,李远珍,等.肝硬化患者血清Ca125、Ca199、总胆汁酸、胆碱酯酶水平及相关性分析[J].医学检验与临床,2013,24(1):27-28.
[8]王丽.肝硬化Child-Pugh评分与血清CA125、CA199水平的关系[J].胃肠病学和肝病学杂志,2015,24(2):210-212.
[9]余剑英,黄柏英.血清CA125、CA199对肝硬化和肝癌的诊断价值[J].中国医师杂志,2004,6(2):266-267.
[10]邱正强.血清CEA、AFP、CA199、CA125在肝炎及肝硬化患者中的检测意义[J].湖南师范大学学报(医学版),2017,14(3):171-174.
[2] Oliveira MS,Silva RPM,Valle SDCND,et al. Chronic hepatitisB and D:prognosis according to Child-Pugh score[J]. Rev BrasEnferm,2017,70(5):1048-1053.
[3]代伟伟,刘正新,徐宝宏.肝硬化和肝癌患者血清CA125、CA199、AFP和CEA水平变化[J].实用肝脏病杂志,2017,20(1):81-84.
[4]黄喜岷,邱建国,洪睿珂.肝硬化患者血清CA125水平与Child-Pugh分级、CHE及腹水量相关性分析[J].肝胆胰外科杂志,2016,28(1):13-16.
[5]吴,李兆勇.肝硬化患者中血清CA125检测的临床意义[J].吉林医学,2018,39(5):956-958.
[6]孙成都,孙刚,郭明洲,等.血清CA125在肝硬化患者中的临床意义及相关因素研究[J].胃肠病学和肝病学杂志,2014,23(5):501-505.
[7]何淑妃,利旭辉,李远珍,等.肝硬化患者血清Ca125、Ca199、总胆汁酸、胆碱酯酶水平及相关性分析[J].医学检验与临床,2013,24(1):27-28.
[8]王丽.肝硬化Child-Pugh评分与血清CA125、CA199水平的关系[J].胃肠病学和肝病学杂志,2015,24(2):210-212.
[9]余剑英,黄柏英.血清CA125、CA199对肝硬化和肝癌的诊断价值[J].中国医师杂志,2004,6(2):266-267.
[10]邱正强.血清CEA、AFP、CA199、CA125在肝炎及肝硬化患者中的检测意义[J].湖南师范大学学报(医学版),2017,14(3):171-174.