标题：AFP、AFU、CEA和CA19-9联合检测对原发性肝癌的诊断价值

      作者：陈昌达 1，陈超群 1，卢盛祥 1，李就文 2    东莞市东部中心医院检验科 1、输血科 2，广东 东莞 523573

      卷次： 2021年32卷4期

      【摘要】 目的 探讨血清甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)、癌胚抗原(CEA)、糖链抗原(CA19-9)联合检测应用于原发性肝癌的临床诊断价值。方法 选取2017年1月至2020年1月东莞市东部中心医院收治的98例原发性肝癌患者(A组)、98例肝硬化患者(B组)和98例健康体检者(C组)作为研究对象。比较各组受检者的血清AFP、AFU、CEA、CA19-9水平，血清肿瘤标志物检测阳性率，以及单个检测与联合检测的敏感度和特异度。结果 A组患者的血清AFP、AFU、CEA、CA19-9水平分别为(289.7±43.5) ng/mL、(209.4±67.8) U/L、(20.3±5.7) ng/mL、(85.6±11.9) U/mL，明显高于B组的(14.1±2.4) ng/mL、(29.2±5.6) U/L、(1.8±0.4) ng/mL、(22.9±5.4) U/mL和C组的(6.3±1.8) ng/mL、(15.4±3.3) U/L、(1.2±0.3) ng/mL、(13.1±2.6) U/mL，且B组明显高于C组，差异均有统计学意义(P<0.05)；A组患者的血清AFP、AFU、CEA、CA19-9检测阳性率分别为64.3%、43.9%、25.5%、21.4%，明显高于B组的10.2%、9.2%、6.1%、4.1%和C组(均为0)，且B组明显高于C组，差异均有统计学意义(P<0.05)；联合检测原发性肝癌的敏感度为86.4%，明显高于AFP (60.8%)、AFU (44.3%)、CEA (23.4%)和CA19-9 (49.1%)的单一检测，差异均有统计学意义(P<0.05)，而联合检测的特异度和单一检测比较，差异无统计意义(P>0.05)。结论 AFP、AFU、CEA、CA19-9联合检测能够提高原发性肝癌诊断的敏感度，值得临床推广。
      【关键词】 原发性肝癌；血清甲胎蛋白；α-L-岩藻糖苷酶；癌胚抗原；糖链抗原；诊断
      【中图分类号】 R735.7 【文献标识码】 A 【文章编号】 1003—6350（2021）04—0485—03

Application of combined detection of serum alpha fetoprotein, α-L-fucosidase, carcinoembryonic antigen, andcarbohydrate antigen in the diagnosis of primary liver cancer.
CHEN Chang-da 1, CHEN Chao-qun 1, LUSheng-xiang 1, LI Jiu-wen 2. Department of Clinical Laboratory 1, Department of Blood Transfusion 2, Dongguan EastCentral Hospital, Dongguan 523573, Guangdong, CHINA
【Abstract】 Objective To investigate the clinical value of combined detection of serum alpha fetoprotein(AFP), α-L-fucosidase (AFU), carcinoembryonic antigen (CEA), and carbohydrate antigen (CA19-9) in patients withprimary liver cancer. Methods From January 2017 to January 2020, 98 patients with primary liver cancer (group A),98 patients with liver cirrhosis (group B), and 98 healthy persons (group C) were selected as the research objects. The se-rum levels of AFP, AFU, CEA, CA19-9, the positive rate of serum tumor markers, and the sensitivity and specificity ofsingle detection and combined detection were compared. Results The serum levels of AFP, AFU, CEA, and CA19-9in group A were (289.7±43.5) ng/mL, (209.4±67.8) U/L, (20.3±5.7) ng/mL, (85.6±11.9) U/mL, which were significantlyhigher than (14.1±2.4) ng/mL, (29.2±5.6) U/L, (1.8±0.4) ng/mL, (22.9±5.4) U/mL in group B, and (6.3±1.8) ng/mL,(15.4±3.3) U/L, (1.2±0.3) ng/mL, (13.1±2.6) U/mL in group C (P<0.05); and the levels in group B were also significant-ly higher than those in group C (P<0.05). The positive rates of serum AFP, AFU, CEA, and CA19-9 in group A were64.3%, 43.9%, 25.5%, and 21.4%, respectively, which were significantly higher than 10.2%, 9.2%, 6.1%, 4.1% ingroup B and 0, 0, 0, 0 in group C (P<0.05); the rates in group B were also significantly higher than those in group C(P<0.05). The sensitivity of combined detection of primary liver cancer was 86.4%, significantly higher than that ofsingle detection of AFP (60.8%), AFU (44.3%), CEA (23.4%), and CA19-9 (49.1%), and the differences were statis-tically significant (P<0.05). The specificity of combined detection and single detection had no statistically signifi-cant difference (P>0.05). Conclusion The combined detection of AFP, AFU, CEA, and CA19-9 can improve the sen-sitivity of diagnosis for primary liver cancer and is worthy of clinical promotion.
      【Key words】 Primary liver cancer; Serum alpha fetoprotein (AFP); α-L-Fucosidase (AFU); Carcinoembryonicantigen (CEA); Carbohydrate antigen (CA19-9); Diagnosis·短篇论著·doi:10.3969/j.issn.1003-6350.2021.04.021