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摘要：
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摘要：目的 探讨血清甲胎蛋白（alpha-fetoprotein，AFP）、高尔基体蛋白73（golgi protein 73，
GP73）、α-L-岩藻糖苷酶（alpha-L-fucosidase，AFU）、癌胚抗原（carcinoembryonic antigen，
CEA）和糖类抗原（carbohydrate antigen 199，CA199）联合检测在早期原发性肝癌（primary liver
cancer，PLC）诊断中的应用。方法 选取2015年1月至2017年10月于深圳市人民医院经影像学、实验
室以及病理学确诊的90例早期PLC患者为PLC组，另选择同期于本院治疗的90例肝硬化患者为肝硬化
组，90例健康体检者为健康对照组。采集各研究对象清晨空腹静脉血5 ml，采用酶联免疫法检测血清
GP73，采用罗氏e602电化学发光仪及其配套试剂检测血清AFP、CA199及CEA，采用罗氏701全自动
生化分析仪检测血清AFU，评估上述指标单项及联合检测在早期PLC诊断的应用价值。结果 PLC患者
血清AFP、GP73、AFU、CA199和CEA水平较肝硬化及健康体检者均显著升高（P均＜ 0.05）。血清
AFP、GP73、AFU、CA199和CEA单项检测与5项联合检测在PLC诊断中特异性及阳性预测值的差异
无统计学意义（P均＞ 0.05），但单项指标的准确性、敏感性及阴性预测值均显著低于5项联合检测，
差异有统计学意义（P均 ＜ 0.05）。结论 血清AFP、GP73、AFU、CA199及CEA联合检测可显著提高
早期PLC的诊断率，具有重要的临床指导价值。
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Abstract: Objective To investigate the application value of combined detection of serum alpha-fetoprotein
(AFP), golgi protein 73 (GP73), alpha-L-fucosidase (AFU), carcinoembryonic antigen (CEA) and
carbohydrate antigen 199 (CA199) on the diagnosis of early primary liver cancer (PLC). Methods Total
of 90 cases with early PLC confirmed by imaging examination, laboratory examination and pathological
examination in Shenzhen People’s Hospital from January 2015 to October 2017 were selected as PLC
group. In addition, 90 patients with liver cirrhosis and 90 healthy controls were selected as cirrhosis group
and healthy controls, respectively. Fasting venous blood (5 ml) of each subject were collected. Serum GP73
was detected by enzyme-linked immunosorbent assay; AFP, CA199 and CEA were detected by Roche
2010 electrochemiluminescence analyzer and matching reagent; serum AFU was detected by Hitachi 7600
automatic biochemical analyzer. The value of single and combined detection of the above indexes on the
diagnosis of early PLC were evaluated. Results The levels of serum AFP, GP73, AFU, CA199 and CEA in
patients with PLC were significantly higher than those in cirrhosis group and healthy controls (P ＜ 0.05).
The specificity and positive predictive value of single and combined detection of AFP, GP73, AFU, CA199
and CEA in the diagnosis of PLC had no statistically significant differences (P ＜ 0.05). However, the
accuracy, sensitivity and negative predictive value of single detection were significantly lower than those of
combined detection, the differences were statistically significant (P ＜ 0.05). Conclusion Combined detection
of serum AFP, GP73, AFU, CA199 and CEA can significantly improve the diagnostic rate of early PLC and
has important clinical guiding value.
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