肝硬化和肝癌患者血清CA125、CA199、AFP和CEA水平变化

doi:10.3969/j.issn.1672-5069.2017.01.021

摘要/Abstract

摘要： 目的研究肝硬化和肝癌患者血清癌抗原（CA）125、CA199、甲胎蛋白（AFP）和癌胚抗原（CEA）的变化。方法采用ELISA法检测223例肝硬化患者、97例肝癌患者和120例健康人血清CA125、CA199、AFP和CEA水平。结果肝硬化和肝癌患者血清CA125分别为（261.64±32.47） U/ml和（265.80±30.44） U/ml,CA199分别为（25.73±3.39） U/ml和（30.54±3.29） U/ml,CEA分别为（4.03±0.36） ng/ml和（3.87±0.21） ng/ml,均显著高于健康人[（21.25±7.66） U/ml、（18.57±8.11） U/ml和（3.08±1.05） ng/ml,P<0.05];肝癌患者AFP（【20000.00±453.07） ng/ml】显著高于肝硬化患者[（7.52±2.01） ng/ml,P<0.05];肝硬化Child-Pugh C级患者CA125【（474.52±59.80） U/ml】、CA199【（27.80±5.94） U/ml】和CEA（【5.80±0.63） ng/ml】均显著高于Child-Pugh A级患者[分别为（55.65±8.82） U/ml、（18.81±0.46）U/ml和（3.20±0.10）ng/ml,P<0.05];腹水患者CA125为（385.16±36.09） U/ml、CA199为（26.55±2.87） U/ml、AFP为（13.63±1.82） ng/ml和CEA为（4.85±0.39） ng/ml,均显著高于无腹水患者[分别为（62.75±15.45） U/ml、（19.58±0.75） U/ml、（9.39±1.26） ng/ml和（3.54±0.16） ng/ml,P<0.05];酒精性肝硬化患者血清CA125【（318.48±48.80） U/ml】和CA199【（26.63±3.22） U/ml】显著高于病毒性[（215.77±26.26） U/ml和（19.06±0.64） U/ml,P<0.05]或原发性胆汁性肝硬化患者[（129.73±28.55）U/ml和（18.00±0.00）U/ml,P<0.05];病毒性肝炎肝硬化患者血清AFP（【56.41±26.75） ng/ml】显著高于酒精性或胆汁性肝硬化患者[分别为（5.44±0.30）ng/ml和（7.35±1.47） ng/ml,均为P<0.05],血清CEA【（3.53±0.17） ng/ml】则显著低于酒精性或胆汁性肝硬化患者[分别为（5.19±0.35）n g/ml和（5.73±0.98） ng/ml,均为P<0.05]。结论肝硬化和肝癌患者CA125、CA199、AFP和CEA水平存在差异,肝硬化患者CA125、CA199、AFP、CEA水平与Child-Pugh分级、腹水和病因有关。

关键词: 肝癌, 肝硬化, 糖类抗原125, 糖类抗原199, 甲胎蛋白, 癌胚抗原

Abstract: Objective To investigate the changes of serum carbohydrate antigen（CA）125,CA199, alpha-fetoprotein （AFP） and carcinoembryonic antigen （CEA） in patients with live cirrhosis and primary liver cancer（PLC）. Methods Serum levels of CA125,CA199,AFP and CEA in 440 individuals were detected by ELISA,including 223 patients with liver cirrhosis,97 patients with PLC and 120 healthy persons. Results The levels of CA125 in patients with liver cirrhosis and PLC were （261.64±32.47） U/ml and （265.80±30.44 ） U/ml, CA199 were （25.73±3.39） U/ml and （30.54±3.29） U/ml,CEA were （4.03±0.36） ng/ml and （3.87±0.21） ng/ml,much higher than those[（21.25±7.66） U/ml,（18.57±8.11） U/ml and （3.08±1.05） ng/ml,P<0.05] in healthy persons;serum AFP levels in patients with PLC were（20000.00±453.07） ng/ml,much higher than[（7.52±2.01） ng/ml,P<0.05] in patients with liver cirrhosis;The levels of CA125（474.52±59.80） U/ml],CA199 [（27.80±5.94） U/ml] and CEA [（5.80±0.63） ng/ml] in patients with liver cirrhosis of class C were significantly higher than those of class A [（55.65±8.82） U/ml,（18.81±0.46） U/ml and （3.20±0.10） ng/ml,respectively,P<0.05];The levels of CA125[（385.16±36.09） U/ml],CA199[（26.55±2.87） U/ml],AFP[（13.63±1.82） ng/ml] and CEA [（4.85±0.39） ng/ml] in patients with cirrhotic ascites were higher than those without ascites[（62.75±15.45） U/ml,（19.58±0.75） U/ml,（9.39±1.26） ng/ml and （3.54±0.16） ng/ml,P<0.05];The levels of CA125 [（318.48±48.80）U/ml] and CA199 [（26.63±3.22）U/ml] in patients with alcoholic liver cirrhosis were higher than those in patients with viral cirrhosis [（215.77±26.26）U/ml and（19.06±0.64）U/ml,P<0.05] or in patients with primary biliary cirrhosis [（129.73±28.55）U/ml and（18.00±0.00） U/ml,P<0.05];The level of AFP [（56.41±26.75）ng/ml] in patients with viral cirrhosis was higher than[（5.44±0.30） ng/ml or（7.35±1.47） ng/ml,respectively,P<0.05],while the CEA level[（3.53±0.17） ng/ml] was lower than [（5.19±0.35） ng/ml or（5.73±0.98） ng/ml,P<0.05] in patients with alcoholic liver cirrhosis or primary biliary cirrhosis. Conclusion The serum levels of CA125,CA199,AFP and CEA in patients with liver cirrhosis and PLC were different. The serum levels of CA125,CA199,AFP and CEA in patients with liver cirrhosis were associated with Child-Pugh scores,ascites and etiology.

Key words: Primary liver cancer, Liver cirrhosis, Carbohydrate antigen 125, CA199, Alpha-fetoprotein, Carcinoembryonic antigen

代伟伟, 刘正新, 徐宝宏. 肝硬化和肝癌患者血清CA125、CA199、AFP和CEA水平变化[J]. 实用肝脏病杂志, 2017, 20(1): 81-84.

Dai Weiwei, Liu Zhengxin, Xu Baohong. Serum CA125,CA199,AFP,CEA in patients with cirrhosis and primary liver cancer[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(1): 81-84.

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