【摘要】 目的　寻找有效的适合用于肝炎肝硬化患者肝癌诊断的血清肿瘤标志物。方法　AFP测定应用竞争性放射免疫技术 (RIA) ,岩藻糖苷酶 (AFU)测定应用酶化学技术 ,唾液酶 (SA)测定应用化学法 ,可溶性白介素 2受体 (sIL 2R)和肝细胞生长因子(HGF)的测定应用单克隆抗体双夹心酶联免疫吸附试验 (ELISA)。结果　AFU、AFP和SA三项指标肝癌患者显著高于肝硬化患者 ,P值分别为P =0 .0 2 7,P <0 .0 0 1和P <0 .0 0 1。分别以AFU值 44 0nmol/ml·h-1、AFP测定值 40 0ng/ml、SA测定值 5 90 μg/ml为阳性参考值 ,测定肝癌组患者阳性率分别为 5 7.5 7%、68.0 9%和 3 5 .7%。三者假阳性率分别为 48%、2 0 %和 0 ,以AFP和SA对 41例肝癌进行联合检测 ,其肝癌患者阳性检出率为 80 .49%。肝癌患者血清sIL 2R水平与肝硬化患者及肝炎患者比较无显著差异 ,P >0 .0 5。肝癌患者血清HGF水平低于肝硬化患者以及重症肝炎患者。结论　肝癌患者HGF、sIL 2R和AFU显著高于正常人血清 ,但其升高的水平受肝脏炎症影响较大 ,对肝癌的特异性较差 ,因而不适合应用于肝炎肝硬化患者肝癌的诊断。AFP仍然是最敏感的肝癌血清指标 ,SA具有肿瘤特异性高和不受肝脏炎症干扰的特点 ,适合肝炎肝硬化患者肝癌的诊断 ,联合AFP可以使阳性检出率达 80 .49% ,使更多还原

【Abstract】 Objective To evaluate the value of several serum markers in hepatocellular carcinoma(HCC) diagnoses among hepatitis involved liver cirrhosis(LC) patients. Methods Alpha fucosidase(AFU) and alpha fetoprotein (AFP) were respectively detected by methods of enzymology and radioimmunoassay,sialic acid (SA) was detected by the method of chemistry.Solubel interleukin 2 receptor (sIL 2R) and hepatocyte growth factor(HGF) were detected by monoclonal antibody sandwich ELISA.Results All levels of sIL 2R,HGF,AFU were found to be equally elevated in patients with HCC,cirrhosis and hepatitis,so they seem useless in screening HCC among cirrhosis patients with varying degress hepatitis.The levels of both AFP and SA in HCC patients were increased significantly compared with C patients, P <0.001.When combined AFPF and SA,33 among 41 HCC patients showed positive results,with the sensitivity of 80.45% which was higher than that of AFP(68.29%) and SA(36.59%) separately.Conclusion The diagnostic values of HGF,sIL 2R and AFU were deteriorated greatly by the inflammation persisted in large number liver cirrhosis patients.SA is a new promising serum marker with the characteristic of tumor specific and less interfered with liver inflammation.The greatly enhanced diagnostic value were received when combing AFP with SA.更多还原