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目的研究血清CA125水平在原发性肝癌及肝癌腹水变化中的意义,以及与AFP联合监测对于肝癌早期诊断的意义。方法回顾性研究我院2006年1月-2008年1月入院患者的临床资料(102例),原发性肝癌患者均为手术病理确诊;正常对照组选取我院同期门诊体检患者(78例);分析其血清CA125水平及AFP水平与肝癌诊断以及肝癌腹水分级的关系。结果血清CA125水平在原发性肝癌组(32.48±3.91)U/ml,与对照组(11.05±2.01)U/ml相比明显升高(P<0.05);血清CA125水平在对照组阳性率(0.02%)低于原发性肝癌组阳性率(39.6%);原发性肝癌CA125水平随着腹水增多逐渐增多,两者具有良好相关性(r=0.61,P<0.01);血清AFP水平与肝癌腹水无明显相关性,原发性肝癌AFP水平明显高于对照组(P<0.05)。血清CA125水平对于原发性肝癌诊断的敏感性(40.2%)和特异性(29.8%)都明显低于血清AFP对于肝癌诊断的敏感性(80.1%)和特异性(84.03%),联合检测两种肿瘤标志物可以提高原发性肝癌诊断的敏感性(87.4%),但是特异性有所降低(24.5%)。结论血清CA125水平与肝癌腹水关系密切,血清CA125水平升高的可能原因和腹膜产生增加有关,与肝功能有一定的关系;血清CA125水平升高不能区分良恶性疾病,需联合检测AFP、CA199、CEA等指标。
Objective To study the significance of serum CA125 level in the changes of primary liver cancer and ascites of hepatocellular carcinoma and its significance in the early diagnosis of liver cancer. Methods The clinical data of 102 hospitalized patients from January 2006 to January 2008 in our hospital were retrospectively reviewed. All the patients with primary hepatocellular carcinoma were confirmed by surgery and pathology. In the control group, 78 patients were selected for outpatient examination at the same period in our hospital. ; Analysis of its serum CA125 levels and AFP levels with the diagnosis of liver cancer and liver cancer ascites grade relationship. Results Serum CA125 level was significantly higher in primary hepatocellular carcinoma group (32.48 ± 3.91) U / ml than that in control group (11.05 ± 2.01) U / ml (P <0.05). Serum CA125 level was significantly higher in control group ( 0.02%) was lower than the positive rate of primary liver cancer (39.6%). The level of CA125 in primary hepatocarcinoma increased with the increase of ascites (r = 0.61, P <0.01) The ascites of hepatocellular carcinoma had no significant correlation, and the level of AFP in primary hepatocellular carcinoma was significantly higher than that in control group (P <0.05). The sensitivity (40.2%) and specificity (29.8%) of serum CA125 levels for diagnosis of primary liver cancer were significantly lower than those of serum AFP for diagnosis of liver cancer (80.1%) and specificity (84.03%), Tumor markers increased the diagnostic sensitivity of primary liver cancer (87.4%) but decreased the specificity (24.5%). Conclusions Serum CA125 levels are closely related to ascites of hepatocellular carcinoma. The possible causes of elevated serum CA125 levels are related to the increase of peritoneum and liver function. Elevated serum CA125 level can not differentiate between benign and malignant diseases. Combined detection of AFP, CA199, CEA and other indicators.