摘要
目的研究肿瘤标志物甲胎蛋白(AFP)、糖链抗原125(CA125)、糖链抗原19-9(CA19-9)、癌胚抗原(CEA)在慢性乙肝病毒感染不同病程中的变化规律,为分析其在慢性肝病进程中的临床意义提供依据。方法选取慢性乙型肝炎病毒感染者129例(慢性乙型肝炎41例,乙肝肝硬化39例,其中代偿期14例,失代偿期25例,乙肝肝癌49例)和健康体检者50例,使用电化学发光法检测血清AFP、CA125、CA19-9、CEA水平。结果慢性乙型肝炎、肝硬化、肝细胞癌组中AFP分别为4.35 ng/ml、5.78 ng/ml和60.21 ng/ml,CEA为1.51 ng/ml、1.92 ng/ml和2.45 ng/ml,乙肝肝癌患者血清AFP、CEA水平明显高于其它三组(P<0.05);肝硬化患者血清CA125水平高于其它三组(P<0.05)。对于中-大量腹水的肝硬化患者,血清CA125水平明显高于少量腹水和无腹水的肝硬化患者(P<0.05),且随腹水量的增多呈逐渐上升趋势。三组慢性肝病患者的血清CA19-9与健康体检组比较,差异无统计学意义(P>0.05)。乙肝肝硬化患者血清CA125、CEA与MLED评分呈正相关(Spearman等级相关系数分别为0.62,P<0.05;0.36,P<0.05),CA19-9、AFP与MELD评分的线形相关无统计学意义(P>0.05)。仅CA125与Child-Pugh评分显著相关(Spearman等级相关系数为0.84,P<0.05),CA19-9、AFP、CEA则无统计学意义(P>0.05)。结论对于慢性HBV感染者,血清CA125与腹水量呈正相关,并与肝病严重程度呈正相关,因此CA125可作为辅助指标监测腹水变化及判断预后。非胃肠道肿瘤患者,血清CEA也可随肝病严重程度加重而增高。
Objective To study the significance of serum tumor markers （including AFP, CA125, CA199, CEA） among different stages of chronic hepatitis B virus （HBV） infection, i. e chronic hepatitis, cirrhosis and hepatocelluar carcinoma. Methods We used electrochemilumi- nescence to measure serum AFP, CA125, CA19 -9 and CEA in 129 patients infected by HBV （chronic hepatitis 41 cases ; liver cirrhosis 39 ca- ses, of which compensatory cirrhosis 14 and decompensate cirrhosis 25 cases respectively; hepatoceUular carcinoma 49 cases） and 50 healthy sub- jects. Results AverageAFPwere4.35ng/ml 5.78ng/ml and 60.21ng/ml andCEAwere1.51ng/ml 1.92ng/ml and2.45ng/ml in hepatitis, cirrhosis and carcinoma groups respectively. AFP and CEA in patients with carcinoma group were significantly higher than those of other groups （ P 〈0.05 ）. Both tumor markers increased with the severity of diseases. Liver cirrhotic patients had the highest level of CA125 in all groups （ P 〈 0.05 ）. In cirrhotic patients, those who had medium -large ascites had significantly higher CA125 than those patients who had mild asctites. For cirrhotic patients, serum CA125 and CEA positively correlated with MELD score （ Spearman R =0.62, P 〈0.05; Spearman R =0. 36, P 〈 0.05 ）, but CA19 - 9 and AFP had no linear correlation with MELD score （ P 〉 0. 05 ）. Moreover, CA125 had an obvious linear correla- tion with Child - Pugh score （ Spearman R = 0.84, P 〈 0. 05 ）, but other markers had no correlation at all （ P 〈0. 05 ）. Conclusion For pa- tients chronically infected by HBV, serum CA125 positively correlates with the amount of ascites. More importantly, CA125 and CEA increases with the severity of liver diseases, which suggests CA125 and CEA are candidate marker for monitor of ascites and predictive of prognosis.
出处
《临床和实验医学杂志》
2013年第21期1702-1705,共4页
Journal of Clinical and Experimental Medicine
基金
北京市科技新星计划项目(编号:2009B45)
