摘要目的 探讨肝癌相关肿瘤标志物在不同病因肝癌中的诊断价值以及肿瘤标志物的组合对不同病因肝癌的诊断价值.方法 回顾性分析275例肝癌患者(乙肝相关肝癌102例、丙肝相关肝癌103例和酒精相关肝癌70例)肿瘤标志物甲胎蛋白(alpha-fetoprotein,AFP)、α-L-岩藻糖苷酶(alpha-L-fucosidase,AFU)和异常凝血酶原(des-gamma-carboxy-prothrombin,DCP)的表达水平差异.结果 不同病因肝癌患者中,肿瘤标志物AFP、AFU和DCP表达水平无统计学差异(P＞0.05).在乙肝、丙肝和酒精相关肝癌中,AFP阴性率分别为35％、36％和52％;AFU阴性率分别为57％、72％和58％;DCP阴性率分别为38％,42％和41％.对于乙肝相关肝癌,AFP联合DCP可将检测敏感度由65％提高至76％,AFP联合AFU没有提高肝癌检测的敏感度.对于丙肝相关肝癌,AFP联合DCP和AFU可将检测敏感度由64％提高至79％.对于酒精相关肝癌,AFP联合DCP和AFU可将敏感度由48％提高至78％.结论 不同病因肝癌AFP、AFU和DCP的表达水平无差异.联合检测AFP、DCP和AFU可以提高丙肝和酒精相关肝癌检测的敏感度.联合检测AFP和DCP可以提高乙肝相关肝癌检测的敏感度.

abstractsObjective To evaluate the diagnostic value of biomarkers and their combinations for hepatocellular carcinoma (HCC) among HCC related to different causes.Methods Retrospective analysis was applied for alpha fetal protein (AFP),alpha-L-fucosidase (AFU) and des-gamma-carboxy-prothrombin (DCP) levels among 275 cases of HCC,including hepatitis B virus (HBV) related HCC (n=102),hepatitis C virus (HCV) related HCC (n=103) and alcohol related HCC (n=70).Results The levels ofAFP,AFU and DCP had no statistically significant difference (P＞0.05) among three groups of HCC.For HBV-related HCC,HCV-related HCC and alcohol-related HCC,the negative rates of AFP were 35％,36％ and 52％,respectively;the negative rates of AFU were 57％,72％ and 58％,respectively;and the negative rates of DCP were 38％,42％ and 41％ respectively.For HBV-related HCC,the detection sensitivity of HCC increased from 65％ to 76％ using combination of AFP and DCP while combination of AFP and AFU showed no effect on the sensitivity.For HCV-related HCC,the sensitivity increased from 64％ to 79％ using combination of AFP,AFU and DCP.For alcohol-related HCC,the sensitivity increased from 48％ to 78％ using combination of AFP,AFU and DCP.Conclusions The expression levels ofAFP,AFU and DCP showed no statistically significant difference among HCC related to different causes.For HCV-related HCC and alcohol-related HCC,using combination of AFP,AFU and DCP can improve the detection sensitivity for HCC.For HBV-related HCC,using combination of AFP and DCP can improve the sensitivity for HCC.