Diagnostic value of multiple serum tumor markers for hepatocellular carcinoma

Objective To explore the four tumor markers of alpha-fetoprotein (AFP), α-L-fucosidase(AFU), carbohydrate antigen 199 (CA199) and carcinoembryonic antigen (CEA) and their combined use for primary hepatocellular carcinoma (HCC) diagnosis and treatment value. Methods From February 2016 to August 2018, 92 patients with primary hepatocellular carcinoma (HCC group), 79 patients with benign liver disease (chronic hepatitis and cirrhosis group) and 99 healthy adults (control group) were selected as subjects.The serum levels of four tumor markers in different populations were compared. Results The serum levels of four tumor markers (AFP(192.4±89.3) μg/L、AFU(78.6±25.8) U/L、CA199(107.2±59.5) U/mL、CEA(37.9±14.9) μg/L) were significantly higher than those of benign liver disease group(AFP(17.4±6.3) μg/L、AFU(35.4±17.2) U/L、CA199(29.3±15.2) U/mL、CEA(4.9±1.7) μg/L) and normal people(AFP(4.8±1.1) μg/L、AFU(12.2±3.6) U/L、CA199(6.4±2.3) U/mL、CEA(1.8±0.4) μg/L). There differences had significant (all P<0.05). The abnormal rate of single factor in hepatocellular carcinoma group (AFP 84.8%, AFU 52.2%, CA199 41.3%, CEA35.9%) was significantly higher than that in benign liver disease group (AFP 15.2%, AFU 19.0%, CA19916.5%, CEA13.9%) and normal group (AFP 4.0%, AFU 5.0%, CA199 3.0%, CEA 6.0% ug/L), the difference was statistically significant (all P<0.05). The highest sensitivity was AFP (84.8%) and the highest specificity was AFP and CA199 (91.0%). The sensitivity of combined detection was 94.6% higher than that of single index (AFP 84.8%, AFU52.2%, CA199 41.3%, CEA35.9%). Conclusion The combined detection of AFP, AFU, CA199 and CEA can increase the sensitivity of diagnosis of hepatocellular carcinoma and reduce the rate of missed diagnosis, which will be beneficial to the early diagnosis and treatment of hepatocellular carcinoma. Key words: Hepatocellular carcinoma; Alpha-fetoprotein; Alpha-L-fucosidase; Carbohydrate antigen 199; Carcinoembryonic antigen