异常凝血酶原(PIVKA-Ⅱ)对结直肠癌的辅助诊断价值  

Value of Serum PIVKA-Ⅱ Level in Diagnosis of Colorectal Cancer

作　　者：王堃[1] 喻晶[1] 

机构地区：[1]湖北省肿瘤医院,湖北武汉430079

出　　处：《中国肿瘤》2017年第2期152-155,共4页China Cancer

摘　　要：[目的]评估异常凝血酶原(PIVKA-Ⅱ)在结直肠癌诊断中的应用价值。[方法]用化学发光法检测101例结直肠癌、25例直肠息肉、79名正常对照血清中的PIVKA-Ⅱ、癌胚抗原(CEA)、糖类抗原(CA199)及糖类抗原(CA242)浓度。绘制受试者工作特征曲线(ROC),并进行比较分析。[结果]结直肠癌患者的血清PIVKA-Ⅱ浓度为30.19(18.51~45.85)U/L,显著高于直肠息肉患者的22.48(19.00~26.18)U/L(U=1821.0,P<0.01)以及健康对照组的22.00(18.00~24.02)U/L(U=2660.0,P=0.013)。根据ROC曲线分析,PIVKA-Ⅱ辅助诊断结直肠癌的灵敏度为33.66%,特异性为94.94%。PIVKA-Ⅱ、CEA、CA199、CA242诊断结直肠癌ROC曲线下面积分别为0.518、0.686、0.699、0.557。[结论]PIVKA-Ⅱ检测对结直肠癌的辅助诊断具有一定的价值。联合CEA、CA199、CA242可以提高诊断灵敏度。[Purpose] To assess the value of serum abnormal prothrombin（PIVKA-Ⅱ） level in diagnosis of colorectal cancer. [Methods] Serum levels of PIVKA-Ⅱ,CEA,CA199 and CA242 were determined by chemiluminescent immunoassay（CLIA） in 101 patients with colorectal cancer,25 with rectal polyp and 79 healthy subjects. Receiver operation characteristic（ROC） ananlysis was performed to evaluate the clinical value of these markers in diagnosis of colorectal cancer. [Results] Serum PIVKA-Ⅱlevels in colorectal cancer patients[30.19（18.51~45.85）U/L] were significantly higher than those in rectal polyp patients[22.48（19.00~26.18）U/L]（U=1821.0,P〈0.01） and in healthy controls[22.0（18.00~24.02）U/L]（U=2660.0,P=0.013）. ROC analysis showed that the sensitivity and specificity of PIVKA-Ⅱ in detecting colorectal cancer were 33.66% and 94.94%,respectively. Area under the ROC curve for PIVKA-Ⅱ,CEA,CA199 and CA242 was 0.518,0.686,0.699 and 0.557,respectively. [Conclusions] PIVKA-Ⅱ testing may be used for diagnosis,staging and prognosis of colorectal cancer. The combination of PIVKA-Ⅱ with CEA,CA199 and CA242 may further improve the sensitivity of the tests.

关 键 词：异常凝血酶原 结直肠癌 诊断 

分 类 号：R735.34[医药卫生—肿瘤]