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目的探讨血清甲胎蛋白(AFP)、恶性肿瘤特异性生长因子(TSGF)、α-L-岩藻糖苷酶(AFU)、γ-谷氨酰转肽酶同工酶(GGT)及癌胚抗原(CEA)联合检测在乙肝相关性原发性肝癌(PHC)早期诊断中的临床价值。方法选取本院2014年4月至2016年7月收治的乙肝相关性PHC患者59例作为乙肝相关性PHC组,选取同期收治的乙肝肝硬化患者58例作为乙肝肝硬化组,另选同期健康体检者57例作为对照组,比较3组血清AFP、TSGF、AFU、GGT、CEA表达水平,对比血清AFP、TSGF、AFU、GGT、CEA单独诊断及联合诊断乙肝相关性PHC结果。结果乙肝肝硬化组血清AFP、TSGF、AFU、GGT、CEA水平均高于对照组,差异有统计学意义(均P<0.05);乙肝相关性PHC组血清AFP、TSGF、AFU、GGT、CEA水平均高于乙肝肝硬化组、对照组,差异有统计学意义(均P<0.05)。应用血清AFP、TSGF、AFU、GGT、CEA联合诊断乙肝相关性PHC特异度为80.87%(93/115)、灵敏度为88.14%(52/59)、准确度为83.33%(145/174),均高于血清AFP、TSGF、AFU、GGT、CEA单一诊断,差异有统计学意义(均P<0.05)。结论血清AFP、TSGF、AFU、GGT、CEA联合检测对乙肝相关性PHC早期诊断应用价值较高,可显著提高诊断的特异度、灵敏度及准确度。
Objective To investigate the effects of serum AFP, TSGF, AFU, GGT and carcinoembryonic antigen (CEA) combined detection in the early diagnosis of hepatitis B-related primary liver cancer (PHC). Methods From April 2014 to July 2016 in our hospital, 59 patients with hepatitis B-associated PHC were enrolled as hepatitis B-related PHC group. Fifty-eight patients with hepatitis B cirrhosis were selected as hepatitis B cirrhosis group during the same period, (57 cases) as the control group. The serum levels of AFP, TSGF, AFU, GGT and CEA were compared among the three groups. Serum levels of AFP, TSGF, AFU, GGT and CEA were separately diagnosed and combined to diagnose hepatitis B-related PHC. Results Serum levels of AFP, TSGF, AFU, GGT and CEA in patients with hepatitis B cirrhosis were significantly higher than those in controls (all P <0.05). Serum levels of AFP, TSGF, AFU, GGT and CEA Were higher than hepatitis B cirrhosis and control group, the difference was statistically significant (P <0.05). The specificity of combined detection of serum AFP, TSGF, AFU, GGT and CEA was 80.87% (93/115), the sensitivity was 88.14% (52/59) and the accuracy was 83.33% (145/174) Higher than serum AFP, TSGF, AFU, GGT, CEA single diagnosis, the difference was statistically significant (P <0.05). Conclusions Combined detection of serum AFP, TSGF, AFU, GGT and CEA has a higher value in early diagnosis of hepatitis B-related PHC, which can significantly improve the specificity, sensitivity and accuracy of diagnosis.