血清铁蛋白、甲胎蛋白异质体3联合腓骨蛋白-1检测诊断肝细胞癌的价值分析  

Value of Serum Ferritin, Alpha-Fetoprotein Variant 3 Combined with Fibulin-1 in the Diagnosis of Hepatocellular Carcinoma

作　　者：张莉[1] ZHANG Li(The 7th People’s Hospital of Zhengzhou City,He’nan Province 450006)

机构地区：[1]河南省郑州市第七人民医院,450006

出　　处：《医学理论与实践》2020年第14期2247-2249,2240,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨血清铁蛋白(FER)、甲胎蛋白异质体3(AFP-L3)联合腓骨蛋白-1(fibulin-1)检测诊断肝细胞癌(HHC)的价值。方法:将2017年1月—2018年3月在我院接受治疗的肝病患者765例以及230例健康体检者作为研究对象,765例肝病患者中包括307例HHC患者(以病理组织学诊断作为肝癌诊断与分型的金标准,其中112例进行手术治疗,作为术后对照组)为HHC组、187例肝硬化(LC)患者为LC组、271例慢性肝炎(CHS)患者为CHS组,230例健康体检者为对照组。通过酶联免疫吸附试验测定四组的AFP-L3与fibulin-1蛋白水平,通过电化学发光法检测血清中的FER水平。结果:HHC组FER、AFP-L3均高于其他三组(P<0.05),HHC组fibulin-1蛋白水平低于其他三组(P<0.05),LC组、CHS组FER、AFP-L3和fibulin-1蛋白水平与对照组比较差异无统计学意义(P>0.05)。手术前FER、AFP-L3均高于手术后(P<0.05),随着病情发展,Ⅰ期、Ⅱ期、Ⅲ期及Ⅳ期患者的FER、AFP-L3逐步上升且均高于术后对照组(P<0.05),手术前fibulin-1蛋白水平低于其手术后(P<0.05),且Ⅰ期、Ⅱ期、Ⅲ期及Ⅳ期患者的fibulin-1蛋白水平逐步下降且均低于术后对照组(P<0.05),术后对照组FER、AFP-L3均高于健康对照组(P<0.05),术后对照组fibulin-1蛋白水平低于健康对照组(P<0.05),FER、AFP-L3与fibulin-1蛋白联合检测的灵敏度、特异度及准确率均高于单项检测(P<0.05);FER、AFP-L3与fibulin-1蛋白联合检测的漏诊率与误诊率均低于单项检测(P<0.05)。结论:血清FER、AFP-L3联合fibulin-1有望作为诊断HHC的新生物学标志物,为HCC早期诊断,临床HHC治疗预案的制订提供参考。Objective:To investigate the value of serum ferritin(FER), alpha-fetoprotein variant 3(AFP-L3) combined with fibulin-1 in the diagnosis of hepatocellular carcinoma(HHC).Methods:765 patients with liver diseases who were treated in the hospital from January 2017 to March 2018 and 230 healthy subjects were enrolled in the study. Among 765 patients with liver diseases, there were 307 patients with HHC(HHC group)(with histopathological diagnosis as the golden standard for diagnosis and typing of liver cancer,112 cases treated with surgery and included in the postoperative control group), 187 patients with liver cirrhosis(LC)(LC group) and 271 patients with chronic hepatitis(CHS)(CHS group). 230 healthy subjects were included in the control group.Levels of AFP-L3 and fibulin-1 were determined by enzyme-linked immunosorbent assay, and serum FER levels were detected by electrochemiluminescence.Results:FER and AFP-L3 in HHC group were higher than those in the other three groups(P<0.05) while the level of fibulin-1 was lower than that in the other three groups(P<0.05). There were no significant differences in levels of FER, AFP-L3 and fibulin-1 between LC group, CHS group and the control group(P>0.05). FER and AFP-L3 were increased operation(P<0.05). With the development of the disease, FER and AFP-L3 at stage Ⅰ,Ⅱ,Ⅲ and Ⅳ gradually increased and were higher than those in the postoperative control group(P<0.05). The fibulin-1 level decreased after operation(P<0.05), and the level at stage Ⅰ,Ⅱ,Ⅲ and Ⅳ decreased gradually and was lower than that in the postoperative control group(P<0.05). FER and AFP-L3 in the postoperative control group were higher than those in the healthy control group(P<0.05), while the fibulin-1 level was lower than the healthy control group(P<0.05).The sensitivity,specificity and accuracy of the combined detection of FER, AFP-L3 and fibulin-1 were higher than single detection(P<0.05);the missed diagnosis rate and misdiagnosis rate of FER, AFP-L3 and fibulin-1 were lower than single detec

关 键 词：血清铁蛋白 甲胎蛋白异质体3 腓骨蛋白-1 联合检测 肝细胞癌 

分 类 号：R446.11[医药卫生—诊断学] R735.7[医药卫生—临床医学]