目的 探讨CT扫描联合肿瘤标 志物水平检测在肝癌患者临床诊断中的 价值。方法 选取2013年4月-2015年4月 收治的57例经病理检查确诊原发性肝癌 (PHC)患者为研究对象,纳入观察组，均 予以病理检查、实验室检查和CT扫描。 将同期入院就诊的40例肝良性肿瘤患者 及40例健康体检志愿者分别纳入对照B 组和对照C组，记录其癌胚抗原(CEA)和 甲胎蛋白异质体3(AFP-L3)水平，病理 检查为“金标准”，评估单纯CT扫描、 单纯肿瘤标志物检查及联合检查在肝肿 瘤临床诊断及良恶性鉴别诊断中的准确 性差异。结果 观察组、对照B组、对照 C组三组患者血清CEA和AFP-L3水平及阳 性率对比均有统计学意义(P<0.05)；其 中观察组>对照B组>对照C组(P<0.05)。 CT平扫、肿瘤标志物水平检测和联合检 查等三种检查方法在肝肿瘤临床诊断 中的准确性分别为85.4%(117/137)、 73.0%(100/137)和95.6%(131/137)；上 述三种检查方法在PHC鉴别诊断中的准确 性分别为83.5%(81/97)、68.0%(66/97) 和94.9%(92/97)。结论 CT扫描联合肝癌 肿瘤标志物水平检测可有效提升PHC患者 早期诊断准确性，对后续针对性治疗工 作的顺利开展有利。

Objective To explore the value of CT scan combined with detection of tumor marker levels in the diagnosis of patients with hepatic carcinoma. Methods 57 patients with primary hepatic carcinomas (PHC) confirmed by pathological examination in our hospital between April 2013 and April 2015 were selected as the study object and were included in the observation group. All the patients underwent pathological examination, laboratory examination and CT scan. Another 40 patients with benign hepatic carcinomas and 40 healthy volunteers who were admitted into the hospital in the same period were included in the control group B and control group C, respectively. The levels of carcinoembryonic antigens (CEA) and alpha fetal protein variants 3 (AFP-L3) were recorded. The results of pathological examination were taken as the golden standard to evaluate the differences in accuracy rates of single CT scan, single tumor marker examination and the combined examination in the clinical diagnosis of hepatic carcinomas and differential diagnosis of benign and malignant carcinomas. Results The differences in levels of serum CEA and AFP-L3 and positive rates between the observation group, control group B and C were statistically significant (P<0.05); Besides, the observation group > control group B > control group C (P<0.05). The accuracy rates of CT scan, detection of tumor marker levels and the combined examination in the clinical diagnosis of hepatic carcinomas were 85.4% (117/137), 73.0% (100/137) and 95.6% (131/137), respectively; The accuracy rates of the above mentioned three methods in the differential diagnosis of PHC were 83.5% (81/97), 68.0% (66/97) and 94.9% (92/97), respectively. Conclusions CT scan combined with detection of tumor marker levels can effectively improve the accuracy of early diagnosis of patients with PHC and it is good for the successful development of follow-up targeted treatment.