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目的:探讨7种血清肿瘤标志物(TM)对肝癌的诊断价值,并筛选出对原发性肝癌(PHC)有价值的TM组合。方法:采用免疫化学发光法测定甲胎蛋白(AFP)、糖链抗原199(CA19-9)、糖链抗原125(CA125)、癌胚抗原(CEA)水平;用连续监测法测定α-L-岩藻糖苷酶(AFU)、r-谷氨酰转移酶(r-GT)、碱性磷酸酶(AKP)。共检测了78例PHC患者和92例肝硬化患者、75例肝炎组及58例健康成人。结果:平行试验敏感性达100%和系列试验特异性达99%的组合有AFP+CA125+r-GT、AFP+AKP+r-GT、AFP+AKP+r-GT+CA199、AFP+CA199+r-GT;总阳性似然比高的组合有AFP+CA125+AKP、AFP+CA199+AKP、AFP+AKP+r-GT。结论:对PHC患者合理的组合为AFP+CA125+AKP、AFP+CA199+AKP、AFP+AKP+r-GT。
Objective: To investigate the diagnostic value of seven serum tumor markers (TM) for hepatocellular carcinoma (HCC) and to screen out the TM combinations that are valuable for primary hepatocellular carcinoma (PHC). Methods: The levels of AFP, CA19-9, CA125 and CEA were measured by immunochemiluminescence. The content of α-L- Fucosidase (AFU), r-glutamyl transferase (r-GT), alkaline phosphatase (AKP). A total of 78 patients with PHC and 92 patients with cirrhosis, 75 patients with hepatitis and 58 healthy adults were examined. RESULTS: AFP + CA125 + r-GT, AFP + AKP + r-GT, AFP + AKP + r-GT + CA199 and AFP + CA199 + AFP were combined in a parallel assay with a sensitivity of 100% and a series of experiments with a specificity of 99% r-GT; AFP + CA125 + AKP, AFP + CA199 + AKP, AFP + AKP + r-GT with a high overall positive likelihood ratio. Conclusion: The reasonable combinations of AFP + CA125 + AKP, AFP + CA199 + AKP, AFP + AKP + r-GT for PHC patients.