CT combined with tumor markers in the diagnosis and prognosis of hepatocellular carcinoma.

Purpose: To investigate the application values of CT combined with tumor markers (TM) in the diagnosis and prognosis of hepatocellular carcinoma (HCC).
Methods: 62 HCC patients were selected as the study group and all of them had undergone hepatectomy. In addition, 40 healthy subjects composed the control group. Blood samples were collected preoperatively from the subjects of the study group, and serum alpha fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) levels were determined by radioimmunoassay. The correlation between serum TM levels and clinicopathological features was investigated by pathological examination. The imaging features of HCC were explored by spiral CT plain scanning and enhanced scanning. The diagnostic efficiency of single detection of TM, combined detection of TMs and combined detection of TMs and CT was analyzed by receiver operating characteristic (ROC).
Results: The levels of serum AFP, CA19-9 and CEA in HCC patients were significantly higher than those in the control group (p<0.05). Patients with low differentiation and distant metastasis had higher levels of AFP, CA19-9 and CEA (p<0.05) compared with patients with high differentiation and no distant metastasis. There were no significant differences in TM levels in HCC patients with different age, gender and clinical stages (p>0.05). The ROC analysis showed that the single detection of serum AFP, CEA or CA19-9 had lower specificity and sensitivity compared with the combined detection of the three TMs (p<0.05). The combined CT examination could achieve a specificity of 95.71% and a sensitivity of 87.47%, superior to the combined detection of the TMs (p<0.05). Eight HCC patients relapsed within 6 months after operation. Compared with those before operation, the levels of serum AFP, CA19-9 and CEA in the relapsed patients were increased significantly, and the TM levels were higher than those in patients without relapse (p<0.05).
Conclusions: The detection of serum AFP, CA19-9 and CEA combined with CT can overcome the deficiency of single detection, avoid misdiagnosis and missed diagnosis, and increase significantly the positive detection rate of HCC.