甲胎蛋白及甲胎蛋白异质体L3对原发性肝细胞癌的诊断价值  

Diagnostic value of alpha fetoprotein and alpha fetoprotein L3 in primary hepatocellular carcinoma

作　　者：亓艳[1] 吴天歌[1] 王照艳[1] QI Yan;WU Tiange;WANG Zhaoyan(Department of Laboratory,Qingdao Municipal Hospital,Qingdao 266011,Shandong,China)

机构地区：[1]青岛市市立医院检验科,山东青岛266011

出　　处：《癌症进展》2020年第17期1774-1777,共4页Oncology Progress

摘　　要：目的探讨甲胎蛋白(AFP)、甲胎蛋白异质体L3(AFP-L3)对原发性肝细胞癌(HCC)的诊断价值。方法选取92例原发性HCC患者、103例肝脏良性病变患者及90例健康体检者,分别作为肝癌组、良性肝病组及对照组。比较3组研究对象的血清AFP、AFP-L3水平及阳性表达率。以病理检查结果为金标准,分析AFP、AFP-L3单独及联合诊断HCC的灵敏度、特异度、阳性预测值、阴性预测值、准确度,采用Kappa一致性检验分析各诊断方法与病理检查结果的一致性。采用受试者工作特征(ROC)曲线评价血清AFP、AFP-L3单独及联合检测对HCC的诊断价值。结果肝癌组患者的血清AFP、AFP-L3水平及阳性表达率均高于良性肝病组和健康对照组,差异均有统计学意义(P﹤0.05)。血清AFP、AFP-L3单独诊断HCC的灵敏度分别为71.74%、56.52%,κ值分别为0.60、0.50,曲线下面积分别为0.793、0.733,二者联合诊断的灵敏度为89.13%,κ值为0.71,曲线下面积为0.868。结论血清AFP和AFP-L3单独检测对HCC均具有一定的诊断价值,但诊断准确性较低,二者联合检测能够提高诊断的灵敏度和准确度,以减少漏诊病例。Objective To investigate the diagnostic value of alpha fetoprotein(AFP)and alpha fetoprotein L3(AFP-L3)in primary hepatocellular carcinoma(HCC).Method A total of 92 patients with primary HCC,103 patients with benign liver diseases and 90 healthy subjects were enrolled and divided into liver cancer group,benign liver disease group and healthy control group.The levels and positive expression rates of serum AFP and AFP-L3 were detected and compared among the three groups.The results of pathological examination were set as the golden standard,then the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of AFP and AFP-L3 alone or in combination in the diagnosis of HCC were analyzed.Kappa consistency test was used to analyze the consistency of the diagnosis methods based on serum markers and the pathological examination results.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum AFP and AFP-L3 alone and in combination for HCC.Result Both the levels and positive rates of serum AFP and AFP-L3 in liver cancer group were higher than those in benign liver disease group and healthy control group,and the differences were statistically significant(P<0.05).The independent sensitivity of serum AFP and AFP-L3 in the diagnosis of HCC were 71.74%and 56.52%,the Kappa values were 0.60 and 0.50,and the area under the curve were 0.793 and 0.733,respectively.The sensitivity of the combined diagnosis was 89.13%,the Kappa value was 0.71,and the area under the curve was 0.868.Conclusion Detection of serum AFP and AFP-L3 individually has certain diagnostic value for HCC,but the diagnostic accuracy is still low.Combined detection of the two markers could improve both the sensitivity and accuracy of diagnosis and thus reduce missing cases.

关 键 词：甲胎蛋白 甲胎蛋白异质体L3 原发性肝细胞癌 受试者工作特征曲线 诊断价值 

分 类 号：R735.7[医药卫生—肿瘤]