血清AFP-L3、GP73检测联合CT扫描在肝细胞癌诊断中的价值  

Diagnostic value of serum AFP- L3,GP73 and CT scan parallel use in diagnosis of hepatocellular carcinoma

作　　者：贾红莲[1] 黄彩云[2] 宋君利[2] 李世龙[2] 周秀艳[2] 王晓蕊[3] 

机构地区：[1]唐山市乐亭县医院,河北唐山063699 [2]唐山市人民医院,河北唐山063000 [3]唐山市协和医院,河北唐山063000

出　　处：《现代肿瘤医学》2015年第1期101-103,共3页Journal of Modern Oncology

摘　　要：目的:检测肝病患者血清中甲胎蛋白异质体(AFP-L3)和高尔基体蛋白73(GP73)浓度,分析肝病患者病灶CT平扫加增强扫描后经处理技术得到二维及三维重建图像,探讨联合运用AFP-L3、GP73浓度检测与CT扫描两种技术在肝细胞癌(hepatocellular carcinoma,HCC)诊断中的价值。方法:采用酶联免疫吸附法检测肝病患者血清AFP-L3、GP73浓度,运用受试者工作特征曲线(recover operation characteristic,ROC)确定AFP-L3、GP73浓度诊断HCC的cut-off值。分析141例肝病患者总共164个病灶的CT扫描后经处理技术得到二维及三维重建图像而诊断HCC,探讨采用AFP-L3、GP73浓度测定与CT增强扫描及这两种方法联合应用在HCC的检出与定性诊断方面的价值。结果:HCC组AFP-L3浓度(113.58±63.62)ng/ml明显高于良性肝病组[(23.19±34.54)ng/ml,P<0.001],绘制AFP-L3浓度诊断HCC的ROC曲线,AFP-L3浓度38.47ng/ml为诊断HCC的cut-off值,诊断敏感性为81.08%,特异性为88.06%,诊断正确率为87.23%;HCC组GP73浓度(126.55±49.56)ng/ml明显高于良性肝病组[(56.97±26.48)ng/ml,P<0.001],绘制GP73浓度诊断HCC的ROC曲线,GP73浓度69.44ng/ml为诊断HCC的cut-off值,诊断敏感性为75.68%,特异性为91.04%,诊断正确率为88.65%。CT扫描诊断HCC的灵敏度为82.43%,特异度为91.04%,诊断正确率为90.07%。联合AFP-L3、GP73浓度检测与CT扫描诊断HCC的灵敏度为85.14%,特异度为92.53%,诊断正确率为92.19%。结论:联合运用血清AFP-L3、GP73浓度检测及CT扫描两种技术对HCC诊断灵敏度、特异度、诊断正确率较运用单一技术均有所提高,联合运用两种技术对HCC的准确早期诊断具有积极的意义。Objective：To explore the value of detecting the serum AFP-L3,GP73 level,CT scanning and parallel use the two kinds of technologies in the early diagnosis of hepatocellular carcinoma（ HCC）. Methods：To use ELISA method to test the serum AFP-L3 and GP73 levels,ROC curve to determine the cut-off level to diagnose HCC. To analyze 164 lesions of 141 patients with liver diseases lesions by CT scan and three dimensional reconstruction ima-ges. To explore the value of parallel use AFP-L3,GP73 and CT scan in HCC diagnosis. Results：The average level of AFP-L3 in the patients with HCC was（113. 58 ± 63. 62）ng/ml significantly higher than those the patients with be-nign liver diseases[（23. 19 ± 34. 54）ng/ml,p〈0. 001]. Taking AFP-L3 level≥38. 47ng/ml as diagnostic crite-ria,the sensitivity of AFP-L3 level in HCC diagnosis was 81. 08% and the specificity was 88. 06%,the accuracy was 87. 23%. The average level of GP73 in the patients with HCC was（126. 55 ± 49. 56 ）ng/ml significantly higher than those the patients with benign liver diseases[（ 56. 97 ± 26. 48）ng/ml,p〈0. 001]. Taking GP73 level≥69. 44ng/ml as diagnostic criteria,the sensitivity of GP73 level in HCC diagnosis was 75. 68% and the specificity was 91. 04%,the accuracy was 88. 65%. Use CT scan in HCC diagnosis,the sensitivity was 82. 43%,the specificity was 91. 04%,the accuracy was 90. 07%. Parallel serum AFP-L3,GP73 level and CT scan images in HCC diagnosis,the sensitivity was 85. 14%,specificity was 92. 53%,accuracy was 92. 19%. Conclusion：The diagnostic sensitivity,spe-cificity and accuracy were higher of parallel use AFP-L3/AFP and CT scan in the diagnosis of HCC compared with application of one single way,parallel use two kinds of methods for accurate early diagnosis of HCC is useful.

关 键 词：甲胎蛋白异质体 高尔基体蛋白73 CT扫描 肝细胞癌 

分 类 号：R735.7[医药卫生—肿瘤]