摘要
目的探讨乙肝肝硬化患者接受治疗期间肿瘤标志物变化的临床意义。方法选取医院收治的慢性乙肝病毒感染患者139例作为研究对象,其中慢性乙型肝炎患者61例,乙肝肝硬化47例(代偿期17例,失代偿期30例),乙肝肝癌31例,选取健康志愿者50例作为对照组,检测糖链抗原125(CA125)、甲胎蛋白(AFP)、癌胚抗原(CEA)水平;并比较肝硬化临床病理与肿瘤标志物的关系;肝硬化组给予马来酸恩替卡韦片口服,0.5mg/d,持续24个月,对比治疗前、治疗12个月、24个月肿瘤标志物水平变化。结果乙肝肝硬化组CA125、CEA、AFP分别为(285.86±15.39)U/ml、(7.13±1.35)ng/ml、(60.25±9.84)IU/ml显著高于慢性乙肝肝炎组、对照组,显著低于乙肝肝癌组,且肝癌组、慢性乙肝肝炎组、对照组组间两两对比差异显著(P<0.05);肝硬化Child C级组CA125为(387.91±38.19)U/ml显著高于Child A级、B级组(89.31±24.98)U/ml(P<0.05);肝硬化合并腹水组CA125为(359.19±73.67)U/ml显著高于未合并腹水组(96.75±15.86)U/ml(P<0.05);肝硬化患者治疗24个月后CA125、CEA、AFP分别为(14.98±5.06)U/ml、(2.14±1.81)ng/ml、(2.90±0.87)IU/ml均低于治疗12个月、治疗前,且治疗12个月、治疗前比较差异显著(P<0.05)。结论乙肝肝硬化患者会伴随CA125、CEA、AFP升高,且CA125与肝功能分级、有无肝腹水有关,对评估预后有一定监测作用。
Objective To investigate the clinical significance of changes of tumor markers in patients with hepatitis B cirrhosis during treatment.Methods 139 cases of patients infected with chronic hepatitis B virus who were treated in the hospital were selected as the study objects,including 61 cases with chronic hepatitis B,47 cases with hepatitis B cirrhosis（17cases at compensated stage,30 cases at decompensated stage）and 31 cases with hepatitis B liver cancer.50 healthy volunteers were included in the control group.The levels of carbohydrate antigen 125（CA125）,alpha fetal protein（AFP）and carcinoembryonic antigen（CEA）were detected.The relationship between clinical pathology and tumor markers in patients with liver cirrhosis was analyzed;The liver cirrhosis group took oral Entecavir Maleate Tablets,0.5mg/d,lasting for 24 months.The changes of tumor marker levels before the treatment,after 12 months and 24 months of treatment were compared.Results CA125,CEA and AFP in the hepatitis B cirrhosis group[（285.86±15.39）U/ml,（7.13±1.35）ng/ ml,（60.25±9.84）IU/ ml]were significantly higher than those in the chronic hepatitis B group and control group and were significantly lower than those in the hepatitis B liver cancer group.Besides,there were significant differences between the liver cancer group,chronic hepatitis B group and the control group（P〈0.05）;CA125（387.91±38.19）U/ml in the liver cirrhosis Child C level group was significantly higher than that in Child A and B level group [（89.31±24.98）U/ml]（P〈0.05）;CA125in the liver cirrhosis with ascites group（359.19±73.67）U/ml was significantly higher than that in the without ascites group[（96.75±15.86）U/ml]（P〈0.05）;After 24 months of treatment,CA125,CEA and AFP in patients with liver cirrhosis[（14.98±5.06）U/ ml,（2.14±1.81）ng/ml,（2.90±0.87）IU/ml]were lower than those after 12 months of treatment and before treatment.The differences after 12 months of treatment and before treatment were significant（P〈0.05）.Conclusion Patients with hepatitis B cirrhosis are complicated by increased CA125,CEA and AFP.Besides,CA125 is related to liver function level and with or without liver ascites,which has a certain monitoring effect in clinical treatment.
出处
《中国实验诊断学》
2016年第7期1085-1088,共4页
Chinese Journal of Laboratory Diagnosis
