甲胎蛋白在原发性肝癌首诊中的价值

赵春华; 周文峰; 陈维华; 席祯; 张春梅

doi:10.3969/j.issn.1001-5256.2013.09.017

甲胎蛋白在原发性肝癌首诊中的价值

DOI: 10.3969/j.issn.1001-5256.2013.09.017

湖北省宜昌市夷陵医院感染性疾病科

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中图分类号: R735.7
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出版历程
- 收稿日期: 2012-10-10
- 出版日期: 2013-09-20

Clinical significance of α- fetoprotein in initial diagnosis of primary hepatic cancer

Department of Infectious Diseases, Yiling Hospital

摘要

摘要:
目的探讨甲胎蛋白(AFP)在原发性肝癌首诊中的诊断价值。方法回顾性分析177例临床资料相对完善的最终确诊为原发性肝癌(PHC)患者首诊时的AFP及影像学结果,以2011年收治的98例慢性乙型肝炎、82例乙型肝炎肝硬化患者为对照组。计数资料采用χ2检验。结果 177例PHC患者首诊时AFP≥400 ng/ml 93例,20 ng/ml<AFP<400 ng/ml 38例,正常46例,分别占52.54%、21.47%、25.99%,异常率占74.01%,显著高于慢性乙型肝炎组(χ2=106.07,P<0.001)和乙型肝炎肝硬化组(χ2=67.82,P<0.001);177例患者中63例病程中AFP<400 3="">5 cm患者(χ2=8.62,P<0.005);首诊时AFP确诊率低于B超(χ2=30.39,P<0.000)和CT(χ2=84.83,P<0.000)。结论 PHC患者首诊时AFP异常率较高,且AFP水平越高,其诊断价值越大,AFP水平与肿瘤大小有一定关系;也...
- 甲胎蛋白类 /
- 肝肿瘤 /
- 超声检查,多普勒 /
- 体层摄影术,X线计算机
Abstract:
Objective To investigate the value ofα- fetoprotein ( AFP) in the initial diagnosis of primary hepatic cancer ( PHC) . Methods A retrospective analysis was performed on the initial AFP measurement results and imaging findings of 177 patients who had relatively complete clinical data and had a confirmed diagnosis of PHC; 98 patients with chronic hepatitis B ( CHB) and 82 patients with post- hepatitis B cirrhosis ( PHBC) , who were admitted to our department in 2011, were enrolled as controls. The obtained data were subjected to statistical analysis using SAS software; the enumeration data were subjected to chi- square test. Results In the initial examination for the 177PHC patients, 93 ( 52. 54%) had a serum AFP level not lower than 400 ng / ml, 38 ( 21. 47%) had a serum AFP level between 20 ng / ml and 400 ng / ml, and 46 ( 25. 99%) had a normal serum AFP level; the abnormal rate of AFP level was 74. 01%, which was significantly higher than those of CHB group ( χ2= 106. 07, P < 0. 001) and PHBC group ( χ2= 67. 82, P < 0. 001) . Among the 177 PHC patients, 63 ( 35. 59%) had a serum AFP level lower than 400 ng/ml in the course of disease. The serum AFP level was significantly lower in patients with a tumor diameter not larger than 3 cm than in those with a tumor diameter larger than 5 cm ( χ2= 8. 62, P < 0. 005) . In the initial examination, serum AFP level yielded a significantly lower correct diagnosis rate than B- mode ultrasound ( χ2= 30. 39, P < 0. 000) and computed tomography ( χ2= 84. 83, P < 0. 000) . Conclusion The abnormal rate of AFP level is higher in PHC patients than in those with CHB and PHBC during initial examination, and the higher the serum AFP level, the higher its diagnostic value. There is a certain relationship between serum AFP level and tumor size. Attention should also be paid to those with negative results of AFP detection. Dynamic monitoring of AFP level combined with imaging examination is helpful for early and correct diagnosis.
- α-fetoproteins /
- liver neoplasms /
- ultrasonography, doppler /
- tomography, X-ray computed

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参考文献(12)

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