| Objective:Hepatic carcinoma(HCC) is one of the malignant tumors in digestivesystem with higher rate of mortality. Occuring dormantly and lacking oftypical symptoms early, the disease discovered is usually in middle oradvanced stage, and it has not the effective treatment to cure the diease. Soearly diagnosis is extremely important to improve survival and quality of life.Tumor marker is one kind of antigen or bioactive compound that expressin tissue or cells of tumor when its gene, antioncogene or tumor related geneanomaly expressing. Normal tissue and optimum disease scarcely express themarker of tumor. Its expression embodies the existance and development oftumor and the activation，inactivation of tumor related gene. It can be detectedin body fluid and excretion. Ideal marker of tumor should be of highspecificity and suitable for whole population survey.In recent years, tumor markers has become an important method fordiagnosis of HCC. Among them a tire protein a-fetoprotein (AFP) is theimportant index which most widely used at present in the diagnosis ofHCC,but in the clinical work30%~40%of HCC patients AFP was negativeor the level was low, therefore we explored the value of united detection ofAFP and other related factors (PHCA, CA19-9, CEA, AFU, ALP, GGT) indiagnosis of liver cancer, proposed joint tumor markers detection can improvethe diagnosis of liver cancer, and points out which is the best joint way, whatis the best detection method for different index, in order to serve clinicalbetter. Materials and methods:1Group of liver cancer:39cases，male29, female10, aged60.4±13.4.HCC was judged by the Clinical Staging Criterion of Primary Liver Cancer(Chinese anticancer association, Society of Liver Cancer. Guangzhou，China,Sep2001) and were confirmed by operation, intervention and pathology.Group of cirrhosis:40cases, male26, female14, aged40.0±24.5. Diagnosedby combination of clinical manifestation, biochemistry, ultrasound, CT andMRI detection etc. and excluded the position occupied pathological changes inliver. Group of normal control:50cases, male30, female20, aged45.1±32.2.They are healthy classmates or colleages by medical examination of ourhospital.2Collection and handling of specimen: Fasting venous blood5ml wascollected in all subjects to be placed in anticoagulant tubes at roomtemperature.After one hour, Centrifuge the blood samples at3000rpm toseparate the Serum which were stored at-30℃for detection.AFP、CA19-9、CEA was detected by electrochemiluminescence immunoassay (kit providedby Roche company); GGT and ALP were detected by velocity method (kitprovided by BEI JING LEADMAN company); PHCA was detected byEnzyme linked immunosorbent assay(kit provided by Shanghai Blue genecompany);AFU was detected by enzyme chromogenic method(kit providedby BEI JING LEADMAN company).3Statisrical analysis: The measurement data is expressed by X±SD，andthe results were analyzed by T test. The count data is expressed bypercentage，and the results were analyzed byχ2test.The value of P<0.05wasconsidered significant.The cutoff value is defined by ROC curve, assumingthat AUC=1.0is ideal detection index,and AUC <0.5has no diagnostic value.Results:1Compared with normal control group, sera level of AFP、PHCA、CA-199、CEA、ALP and GGT have significant difference (P<0.05) in groups of liver cancer. Compared with cirrhosis, sera level of AFP、PHCA、CA19-9and ALP have significant difference (P<0.05) in groups of livercancer，while AFU、CEA、GGT have no significant difference.2To measure AFP、PHCA、CA19-9、CEA、AFU、ALP and GGTrespectively, the positive rate of the HCC was71.79%、71.79%、61.54%、53.85%、23.08%、28.21%and82.05%, the specificity was94.44%、88.89%、83.33%、86.11%、69.44%、94.44%and41.67%，and the accuracy was82.67%、80.00%、72.00%、69.33%、45.33%、60.00%and62.67%.3In liver cancer group，the combined detection sensitivity for AFP andPHCA was79.49%, the combined detection sensitivity for AFP and CA19-9was84.62%,and the combined detection sensitivity for AFP and CEA was82.05%. The combined detection sensitivity for AFP PHCA and CA19-9was92.33%，which was obviously higher than by respectively (P<0.05), eventhough specificity was slightly decreased.Conclusion:1AFP is the most used fairly specific tumor marker in PHC diagnosis,although it has some rate of misdiagnosis.2PHCA is a new marker of the liver cancer, It has high sensitivity andspecificity. It can improve the diagnosis accuracy and avoid mistakeddiagnosis when combined detection with AFP.3The tumor markers except AFP are valuable of the detection of HCC,especially when the liver cancer is negative for AFP. Howere,at present therehas no any tumor marker can substitute it.Combined detection of two or threetumor markers can improve the detection rate of liver cancer and avoid misseddiagnosis. This has clinical significance. |
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