血浆Dickkopf同源物1检测对肝细胞癌的诊断价值  

Diagnosis Value of Detecting Plasma Dickkopf-1 Patients with Hepatocellular Carcinoma

作　　者：毛丽萍[1] 何义民[1] 韩刚[1] 王跃国[2] 

机构地区：[1]南通市第三人民医院检验科,江苏南通226006 [2]南通大学附属医院,江苏南通226001

出　　处：《现代检验医学杂志》2016年第5期62-65,共4页Journal of Modern Laboratory Medicine

基　　金：2014年度南通市“226工程”培养对象科研项目资助,基金号:CR201401

摘　　要：目的：探讨检测血浆 Dickkopf同源物1（DKK1）对肝细胞癌（HCC）的诊断价值。方法选取2014年11月～2015年12月南通市第三人民医院已确诊的 HCC患者48例，肝硬化（LC）20例，慢性乙型肝炎（CHB）20例，选择排除其他慢性疾病的健康体检者（HC）20例，采用 ELISA方法定量检测血浆中DKK1浓度，同时采用美国雅培 i2000微粒子化学发光免疫分析仪检测其 AFP。同时比较分析其 ROC曲线及相关性。结果 HCC组DKK1水平均显著高于 LC组、CHB组和 HC组（Z＝－4.132～－5.828，P均＜0.001）。DKK1对 HCC诊断价值的 ROC曲线下面积为0.889，95％置信区间为0.831～0.947，DKK1诊断 HCC最佳 cutoff值为565 ng／L，其诊断灵敏度为93.8％，特异度为70％，AFP的 ROC曲线下面积为0.759，95％置信区间为0.667～0.850。DKK1的 AUC显著＞AFP（Z＝2.28，P＝0.022）。DKK1和 AFP两指标间无相关性（r＝0.148，P＝0.316），其中有21例 AFP＜20μg／L而其DKK1＞565 ng／L的诊断临界值。结论检测血浆中DKK1可以作为 AFP诊断 HCC的有效补充，尤其是DKK1对 AFP阴性 HCC患者的早期诊断价值值得关注。Objective To evaluate the diagnosis value of plasma Dickkopf-1（DKK1）in hepatocellular carcinoma （HCC）pa-tients.Methods Selected 48 patients with HCC,20 patients with liver cirrhosis （LC）,20 patients with chronic hepatitis B （CHB）,and all of them were clinically diagnosed in the Third People’s Hospital of Nantong City,chose 20 cases of health examination as healthy controls （HC）,that were ruled out other chronic disease.Enzyme-linked immunosorbent assay （ELISA）and Abbott i2000 microparticle chemiluminescence immunoassay analyzer were used to determine the plasma DKK1 and alpha-fetoprotein （AFP）levels.At the same time,analysesed and compared the receiver operating characteristic （ROC）curve and correlation of the DKK1 and AFP results.Results The plasma level of DKK1 in patients with HCC was significantly higher than that in patients with chronic hepatitis B,cirrhosis and healthy controls （Z=-4.132^-5.828,P〈0.001）.The area under ROC curve （AUC）of plasma DKK1 in the diagnosis of HCC was 0.889 and 95% confidence in-terval was 0.831~0.947,when the Cut-off value of DKK1 was 565 ng/L,the sensitivity was 93.8% and specificity was 70% in diagnosing HCC.The areaunder ROC curve of AFP in the diagnosis of HCC was 0.759 and 95% confidence interval was 0.667~0.850.The AUC of DKK1 was significantly higher than that of AFP （Z=2.28,P=0.022）.DKK1 and AFP in diagnosing HCC were no significantly correlated （r=0.148,P=0.316）.21 patients with AFP under 20μg/L showed higer DKK1 above 565 ng/L in 48 patients with HCC.Conclusion Detection of DKK1 in plasma can be used as a complement of AFP in the diagnosis of HCC,Especially DKK1 early diagnostic value of AFP negative HCC patients is remarkable.

关 键 词：肝细胞癌 DICKKOPF 同源物 1 甲胎蛋白 

分 类 号：R735.7[医药卫生—肿瘤] R730.43[医药卫生—临床医学]