肝硬化不同Child-pugh分级中CA724、CA242、AFP检测的临床分析

发布时间：2019-05-24 15:43

【摘要】：目的检测不同Child-pugh分级肝硬化患者血清及腹水中肿瘤标记物CA724、CA242、甲胎蛋白(AFP)的水平,探讨3个肿瘤标记物对于肝硬化的临床价值。方法选取肝硬化患者82例及健康对照者50例,应用电化学发光免疫分析法检测血清中CA724、CA242及AFP等肿瘤标志物的水平。对于Child-pugh B、C级存在腹水患者抽取腹水,检测其中CA724、CA242及AFP的水平。以ROC曲线判断这些指标对肝硬化的诊断能力。结果肝硬化患者血清CA724、AFP水平较健康对照组明显升高(P0.05),而血清CA242水平较健康对照组差异无统计学意义(P0.05);血清CA724、AFP水平随着Child-pugh分级的升高而逐渐升高,CA242无明显规律性。组间比较,Child-pugh A、B、C级肝硬化中血清AFP比较差异有统计学意义(P0.05),CA724在Child-pugh A级和B级比较差异无统计学意义(P0.05),CA242在Child-pugh分级中差异均无统计学意义(P0.05)。腹水中CA724和AFP随着Child-pugh分级升高而逐渐升高(P0.05)。血清CA242的ROC曲线下面积为0.556,无明显辅助诊断能力。结论血清及腹水CA724、AFP对肝硬化的诊断及评估预后具有一定的临床价值,与肝硬化程度相关,而不适宜选择CA242指标。
[Abstract]:Objective to detect the level of CA724,CA242, alpha-fetoprotein (AFP) in serum and ascitic fluid of patients with liver cirrhosis with different Child-pugh grades, and to explore the clinical value of three tumor markers in liver cirrhosis. Methods 82 patients with liver cirrhosis and 50 healthy controls were selected to detect the levels of tumor markers such as CA724,CA242 and AFP in serum by electrochemiluminescence immunoassay. For Child-pugh B, the levels of CA724,CA242 and AFP were measured in patients with grade C ascitic fluid. The diagnostic ability of these indexes in liver cirrhosis was judged by ROC curve. Results the level of serum CA724,AFP in patients with liver cirrhosis was significantly higher than that in healthy control group (P 0.05), but the level of serum CA242 was not significantly different from that in healthy control group (P 0.05). The level of serum CA724,AFP increased gradually with the increase of Child-pugh grade, and CA242 had no obvious regularity. There was significant difference in serum AFP between Child-pugh A, B, C and C (P 0.05), but there was no significant difference in CA724 between Child-pugh A and B (P 0.05). There was no significant difference in CA242 in Child-pugh grade (P 0.05). CA724 and AFP in ascitic fluid increased gradually with the increase of Child-pugh grade (P 0.05). The area under ROC curve of serum CA242 was 0.556, and there was no obvious auxiliary diagnostic ability. Conclusion CA724,AFP in serum and ascitic fluid has certain clinical value in the diagnosis and prognosis of liver cirrhosis, which is related to the degree of liver cirrhosis, but is not suitable for the selection of CA242 index.
【作者单位】：河北省沧州市中心医院消化内科;河北省沧州市中心医院普外科;河北省沧州市中心医院核医学科;
【分类号】：R575.2

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