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目的用时间分辨荧光检测血循环中肿瘤标志物评价消化系疾病的诊断价值。方法采用时间分辨荧光检测245例消化系良恶性疾病患者和100例健康成人血清肿瘤标志物,癌胚抗原 (CEA)和甲胎蛋白 (hAFP)的水平。结果消化系恶性肿瘤组血清CEA(79.57±224.5)比消化系良性疾病组 (4.03±4.6)明显升高 (P<0.01)增加20倍 ;良性疾病组比健康对照组(2.24±1.22)低度升高<2倍。亚组分析CEA对结直肠癌有较高的特异性和敏感性 ,分别为75.9%和60%。hAFP最佳工作点诊断肝癌敏感性和特异性分别为76%和88%。肝癌病人hAFP明显升高(平均值>500U/ml)比肝硬化组增加90倍 ,而肝硬化比健康人增加<6倍。结论时间分辨荧光检测血循环中的肿瘤标志物具有超敏感特性 ,增强hAFP和CEA对恶性肿瘤特别肝癌、结直肠癌的特异性、敏感性和阳性率 ,有助于消化系良恶性疾病的诊断和鉴别诊断能力
Objective To evaluate the diagnostic value of tumor markers in the blood circulation by time-resolved fluorescence. Methods Serum tumor markers, carcinoembryonic antigen (CEA) and alpha-fetoprotein (hAFP) levels in 245 patients with benign and malignant digestive diseases and 100 healthy adults were detected by time-resolved fluorescence. Results Serum CEA (79.57 ± 224.5) in digestive malignant tumor group was significantly higher than that in benign digestive tract disease group (4.03 ± 4.6) (P <0.01), while that in benign disease group was lower than that in healthy control group (2.24 ± 1.22) Increase <2 times. Subgroup analysis of CEA on colorectal cancer has a high specificity and sensitivity, respectively, 75.9% and 60%. hAFP best point of diagnosis of liver cancer sensitivity and specificity were 76% and 88%. Patients with hepatocellular carcinoma had a significantly higher hAFP (mean> 500 U / ml) than patients with cirrhosis by 90-fold, whereas cirrhosis increased by <6-fold compared with healthy individuals. Conclusion Time-resolved fluorescence detection of tumor markers in the blood circulation has the characteristics of hypersensitivity and enhance the specificity, sensitivity and positive rate of hAFP and CEA for malignant tumors, especially liver cancer, colorectal cancer, which is helpful for the diagnosis of benign and malignant digestive diseases Differential diagnosis ability