特异性γ-谷氨酰转肽酶Ⅱ对原发性肝癌的诊断价值  

Clinical value of hepatoma-specific gamma-glutamyltranspeptidase Ⅱ analysis in diagnosis of primary hepatocellular carcinoma

作　　者：汤琪云 蒋建霞 施瑞华 沈洪[2] 胡赛男[3] 张巧娣 杨学文[2] 梁志超[3] 陈宏兵 

机构地区：[1]南京医科大学第一附属医院消化病科,江苏省210029 [2]江苏省中医院 [3]江苏省肿瘤医院 [4]江苏纵横工贸有限公司

出　　处：《江苏医药》2012年第6期666-668,共3页Jiangsu Medical Journal

摘　　要：目的评估肝癌特异性γ-谷氨酰转肽酶Ⅱ(GGT-Ⅱ)对原发性肝癌(PHC)的诊断价值。方法从3个临床试验中心收集PHC 595例(PHC组),对照组为肝炎后肝硬化或慢性肝炎246例及正常人群166例。采用GGT-Ⅱ检测试剂盒检测GGT-Ⅱ,化学发光法检测甲胎蛋白(AFP)。分析两者对PHC的诊断价值。结果 595例PHC患者中,387例AFP>400μg/L,500例GGT-Ⅱ阳性。GGT-Ⅱ诊断PHC的灵敏度为84.03%,特异度为91.26%,误诊率为8.74%,漏诊率为15.97%,正确率为86.99%,Youden指数为75.30%。而AFP诊断PHC的灵敏度为65.04%,特异度为88.83%,误诊率11.17%,漏诊率34.96%,正确率74.78%,Youden指数为53.85%。GGT-Ⅱ与AFP诊断PHC一致性指标:Kappa=0.2687,95%可信区间(CI)为(0.1929,0.3446)。结论与AFP检测比较,GGT-Ⅱ诊断PHC敏感性好,特异性高,准确度高,误诊和漏诊率较低。Objective To explore the values of detection of hepatoma-specific gamma-glutamyltransferase-Ⅱ（GGT-Ⅱ） in the diagnosis of primary hepatocellular carcinoma（PHC）. Methods A total of 1007 blood samples was collected from three clinical trial centers,which included 595 cases with PHC,246 cases with chronic hepatitis or cirrhosis and 166 normal healthy controls.The GGT-Ⅱ of peripheral blood was detected using the kit and AFP was determined by chemiluminescence method.The results repoted by two methods were analyzed. Results The sensitivity and specificity of GGT-Ⅱ in the diagnosis of PHC were 84.03% and 91.26%,respectively,which were higher than those of alpha fetus protein（AFP）（65.04% and 88.83%）.The misdiagnosis and omission diagnosis rates of GGT-Ⅱ were 8.74% and 15.97%,which were much lower than those of AFP（11.17% and 34.96%）.The accuracy and Youden index of GGT-Ⅱ were 86.99% and 75.30%,while those of AFP were 74.78% and 53.85%,respectively.The consistent index of GGT-Ⅱ and AFP was Kappa=0.2687 with the 95%CI of 0.1929 and 0.3446. ConclusionCompared to AFP examination,the determination of GGT-Ⅱ in peripheral blood has the advantages of higher sensitivity and effectiveness,but less misdiagnosis and omission diagnosis rates,in the diagnosis of PHC.

关 键 词：γ-谷氨酰转肽酶Ⅱ 甲胎蛋白 原发性肝癌 

分 类 号：R735[医药卫生—肿瘤]