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目的：通过对比免疫组化标记物与影像学检查诊断肝癌的特异性与敏感性，探讨两种方法在肝癌诊断中的价值以指导临床诊断。方法：对本院收治的180 例拟诊肝癌的患者行螺旋CT 增强扫描检查，并测定AFP、AFU、SF、CA199 等免疫组化标记物，通过手术或经皮穿刺活检对患者确诊后，比较CT 检查与、AFP、AFU、SF、CA199 四项免疫组化联合检查的特异性与敏感性。结果：特异性比较: AFP、AFU、SF、CA199 的特异性显著低于CT 增强扫描（P<0.05），免疫组化联合检查与CT 增强扫描的特异性无显著差异（P>0.05）；敏感性比较，AFU、SF、CA199、联合检查的敏感性显著低于CT 增强扫描（P<0.05），AFP的敏感性与CT 增强扫描无显著差异（P>0.05）。结论：免疫组化的联合检测可以提高肝癌诊断的敏感性与特异性，因此应对拟诊肝癌的患者首先进行免疫组化联合检测，免疫组化异常患者可进行CT 增强扫描等影像学检查进一步诊断。

英文摘要:

Objective:To discuss the value of immunohistochemical markers and imaging in the diagnosis of hepatocellular by detecting and comparing the specificity and sensitivity of serum.Methods:180 cases with suspected liver cancer who were inspected in our hospital by the spiral CT as well as detected the markers of AFP, AFU, SF, CA199 by the immunohistochemical. Then the patients were diagnosed through surgery or percutaneous biopsy. The specificity and sensitivity that detected by the CT examination and immunohistochemical inspection of AFP, AFU, SF and CA199 were compared and analyzed.Results:The specificity of AFP, AFU, SF and CA199 was significantly lower than that of the CT (P<0.05); There was no significant difference of specificity between the Joint Inspection and CT scan(P>0.05). The sensitivity of the AFU, SF and CA199 detected by the Joint Inspection was significantly lower than that of the CT(P<0.05); There was no significant difference of sensitivity between AFP and CT(P>0.05).Conclusion:Immunohistochemical detection can be combined to improve the sensitivity and specificity when diagnosing the liver cancer. Therefore, we can use immunohistochemistry joint detection for patients with hepatocellular carcinoma, while CT scan and other imaging studies could be used for the patients with abnormal immunohistochemistry.

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