血浆多聚免疫球蛋白受体（PIgR／SC）对肝癌诊断的作用研究  

Role of plasma immunoglobulin receptor （PIgR/SC） in diagnosis of liver cancer

作　　者：黄继超[1] 姜德清[1] 王宗山[2] 温江涛[1] 孙咏梅[1] 柯群刚[1] 郝占伟[1] Huang Jichao Jiang Deqing Wang Zongshan Wen Jiangtao Sun Yongmei Ke Qnagang Hao Zhanwei(Department of Hepatobiliary Surgery,the Second Hospital of Lianyungang, Lianyungang 222023, China Department of ttepatobiliary Surgery, the People＇s Hospital of Ganyu County, Lianyungang 222100, China)

机构地区：[1]连云港市第二人民医院肝胆外科,222006 [2]赣榆县人民医院肝胆外科,222100

出　　处：《中华内分泌外科杂志》2016年第6期491-493,516,共4页Chinese Journal of Endocrine Surgery

基　　金：连云港市卫生局科研课题计划（1228）

摘　　要：目的探讨血浆多聚免疫球蛋白受体（PIgR／SC）对原发性肝癌的诊断价值。方法选取58例原发性肝癌患者、60例肝硬化患者和60例健康志愿者进行研究，抽取患者4ml空腹静脉血，采用电化学发光全自动免疫分析系统检测患者血清中的甲胎蛋白（AFP）浓度，采用自行包被的ELISA检测板和OD值半定量法检测血浆PIgR／SC。肝癌患者手术切除后1周重复检测AFP和PIgR／SC水平。结果肝癌、肝硬化和志愿者3组患者PIgR／SC和AFP水平差异有统计学意义（均P〈0．01），两两分析，肝癌患者PIgR／SC高于肝硬化患者和志愿者（均P〈0．01），肝硬化患者与志愿者差异无统计学意义（P〉0．05）；肝癌患者AFP高于肝硬化患者和志愿者，肝硬化患者高于志愿者，差异均有统计学意义（均P〈0．01）。PIgR／SC诊断原发性肝细胞肝癌的敏感度为89_3％，高于AFP的54．8％；特异性为84．6％，低于AFP的91％；约登指数为0．751，高于AFP的0．458；AUC面积为0．920，高于AFP的0．761。对2种检测指标的AUC比较，差异有统计学意义（Z=3．251，P〈0．05）。结论PIgR／SC在原发性肝癌诊断中的价值可能优于AFP，具有较高的临床意义。Objective To investigate the diagnostic value of PIgR/SC in diagnosis of primary hepatic cancer. Methods 58 patients with primary hepatic cancer, 60 patients with liver cirrhosis and 60 healthy volunteers were studied.4 ml fasting venous blood was collected from all subjects. Serum level of AFP was detected with electrochemical chemiluminescence immunoassay system and plasma PIgR/SC level was detected by ELISA method. The level of PIgR/SC and AFP was detected at one week after surgical resection in patients with hepatic cancer. Results The levels of AFP and PIgR/SC in the three groups were significantly different （P〈0.01）, and PIgR/SC was higher than that in patients with cirrhosis and volunteers （P〈0.01）. There was no significant difference between patients with liver cirrhosis and liver cirrhosis（P〉0.05）. AFP was higher in patients with HCC than patients with cirrhosis and volunteers. AFP was higher in patients with cirrhosis than volunteers, and the difference was statistically significant（P〈0.01 ）. Sensitivity of PIgR/SC and AFP was 89.3% and 54.8%, specificity was 84.6% and 91%, Youden index was 0.751 and 0.458, AUC was 0.920 and 0.761, respectively. There was significant difference in AUC （Z=3.251, P〈0.05） of the two detection indexes for detection of primary hepatic cancer. Conclusion The value of PIgR/SC in diagnosis of primary liver cancer may by higher than that of AFP.

关 键 词：多聚免疫球蛋白受体 原发性肝癌 甲胎蛋白 

分 类 号：R735.7[医药卫生—肿瘤]