目的：探索循环肿瘤细胞(circulating tumor cell,CTC)、经典临床肿瘤标记物甲胎蛋白(alpha fetoprotein,AFP)及癌胚抗原(carcinoembryonic antigen,CEA)对原发性肝癌诊断的临床价值。方法：选取2017年8月至2018年10月间,在我院诊断为原发性肝癌,且接受肝癌根治术的42例患者为实验组,以同期在我院诊断为肝硬化、重症肝炎的42例患者为肝良性病对照组。实验组及对照组均行CTC、AFP、CEA检测,分析比较两组间的阳性率；比较各单测组对肝癌诊断的敏感性、特异性、准确性、准确诊断指数；对各单检测项及联合检测组进行诊断准确性工作特征曲线(ROC)绘制。结果：实验组中CTC、AFP、CEA检测阳性率明显高于对照组；各单独检测项目组其敏感性、特异性、准确性、准确诊断指数比较结果：CTC＞AFP＞CEA,诊断价值依次为：CTC＞AFP＞CEA；联合测试组CTC+AFP+CEA、CTC+AFP、CTC+CEA、AFP+CEA诊断价值依次为：CTC+AFP+CEA=CTC+AFP＞CTC+CEA＞AFP+CEA。结论：CTC和AFP、CEA用于临床患者的原发性肝癌诊断方面均具有明显价值；CTC的诊断敏感性、特异性、准确性、准确诊断指数及诊断价值均优于AFP、CEA；在联合测试组中,最终实验结果表明,CTC联合AFP检测拥有对原发性肝癌诊断的最高效能。

Objective：To explore the clinical value of circulating tumor cells and tumor markers alpha fetoprotein, carcinoembryonic antigen in the laboratory diagnosis of primary liver cancer. Methods：From August 2017 to October 2018, 42 patients diagnosed with primary liver cancer and undergoing radical hepatectomy in our hospital were selected as the experimental group, and 42 patients with liver cirrhosis and severe hepatitis diagnosed in our hospital during the same period were selected as the control group. Both the experimental group and the control group were tested for CTC, AFP, and CEA. The positive rates of CTC, AFP, and CEA between the two groups were analyzed and compared, and the sensitivity, specificity, accuracy, and accuracy of the diagnosis of liver cancer in each single test group were calculated; Finally, draw the receiver operating characteristic curve (ROC) of diagnostic accuracy for each single test item of CTC, AFP, CEA and the combined test group. Results：The positive rates of CTC, AFP and CEA in the liver cancer group were significantly higher than those in the benign liver disease control group; the sensitivity, specificity, accuracy, and accurate diagnosis index of each individual test group were compared: CTC>AFP>CEA; The diagnostic value is : CTC>AFP>CEA; The diagnostic value of the combined test group CTC+AFP+CEA, CTC+AFP, CTC+CEA, AFP+CEA is in order: CTC+AFP+CEA =CTC+AFP>CTC+CEA>AFP+CEA. Conclusion：CTC, AFP and CEA have the same diagnostic value for primary liver cancer; CTC has better diagnostic sensitivity, specificity, accuracy and accurate diagnostic index for primary liver cancer than AFP and CEA single test group; The combined test group CTC+AFP has the highest diagnostic efficiency for liver cancer.