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[目的]探讨血清肿瘤标记物CA125、甲胎蛋白(AFP)在原发性肝癌(PHC)和肝硬化诊断中的临床价值。[方法]对PHC组56例,肝硬化组68例,正常对照组45例,检测血清CA125、AFP水平,并进行分析。[结果]原发性肝癌、肝硬化患者血清CA125浓度显著高于正常对照组(F=4.23～5.72,P﹤0.01),肝癌组与肝硬化组比较(P﹥0.05),差异无统计学意义。原发性肝癌、肝硬化患者AFP浓度均高于正常对照组,原发性肝癌组显著高于肝硬化组(F=4.77～6.45,P﹤0.01)。PHC患者组AFP、CA125灵敏度分别为73.2%、69.6%,与肝硬化组比较(P﹤0.01),差异有统计学意义,其中AFP阳性(AFP﹥25 ng/ml)的原发性肝癌患者中,血清CA125的灵敏度为73.9%,AFP阴性的原发性肝癌患者中,血清CA125的灵敏度为43.6%(P﹤0.05),差异有统计学意义。AFP、CA125联合检测原发性肝癌灵敏度提高到84.9%。[结论]血清AFP、CA125联合检测具有互补作用,可提高PHC的诊断率。
[Objective] To investigate the clinical value of serum tumor markers CA125 and AFP in the diagnosis of primary liver cancer (PHC) and cirrhosis. [Method] 56 cases of PHC group, 68 cases of liver cirrhosis group and 45 cases of normal control group were measured serum CA125, AFP levels, and analyzed. [Results] The serum levels of CA125 in patients with primary hepatic carcinoma and cirrhosis were significantly higher than those in normal control group (F = 4.23-5.72, P <0.01), but there was no significant difference between hepatocellular carcinoma group and cirrhosis group (P> 0.05) . The levels of AFP in patients with primary hepatocellular carcinoma and cirrhosis were significantly higher than those in the normal control group, and significantly higher in patients with primary liver cancer than those with cirrhosis (F = 4.77-6.45, P <0.01). The sensitivity of AFP and CA125 in patients with PHC were 73.2% and 69.6%, respectively, which were significantly different from those in patients with cirrhosis (P <0.01). Among patients with AFP positive (AFP> 25 ng / ml) , The sensitivity of serum CA125 was 73.9%. The sensitivity of serum CA125 was 43.6% (P <0.05) in patients with AFP negative primary liver cancer, the difference was statistically significant. AFP, CA125 combined detection of primary liver cancer sensitivity increased to 84.9%. [Conclusion] The combined detection of serum AFP and CA125 has the complementary effect, which can improve the diagnosis rate of PHC.