血清异常凝血酶原联合甲胎蛋白检测对原发性肝癌的早期诊断意义分析  

Analysis of the Significance of Serum Abnormal Prothrombin Combined with Alpha-Fetoprotein in the Early Diagnosis of Primary Liver Cancer

作　　者：郭振添 李飞 莫伟平[1] 莫海兴 GUO Zhentian;LI Fei;MO Weiping;MO Haixing(Dongguan People's Hospital,Dongguan,Guangdong 523000,China)

机构地区：[1]东莞市人民医院,广东东莞523000

出　　处：《大医生》2020年第10期26-28,共3页Doctor

摘　　要：目的分析血清异常凝血酶原(PIVKA-II)联合甲胎蛋白(AFP)检测对原发性肝癌的早期诊断意义。方法回顾性分析东莞市人民医院2018年6月至2019年6月收治住院并经病理诊断确诊为肝脏疾病患者90例临床资料进行研究,按患者疾病种类将其分为肝炎组(10例)、肝硬化组(38例)、继发性肝癌组(14例)、原发性肝癌(PHC组)(28例)。另外选择同期接受检查的20例健康受试者设为对照组。分析比较各组PIVKA-II及AFP水平。结果与肝炎组、肝硬化组、继发性肝癌组、PHC组与对照组相比,PHC组的血清内AFP以及PIVKA-II水平明显更高(P<0.05)。将对照组视为参照对象,证实使用PIVKA-II在诊断PHC特异性、灵敏性明显比AFP诊断PHC的特异性以及敏感性更好(P<0.05)。联合诊断2[异常凝血酶原和甲胎蛋白阳性为联合诊断(串联)]检测PHC的敏感性比单一检查更好(P<0.05)。联合诊断1[以异常凝血酶原或甲胎蛋白阳性为联合诊断(并联)]检测PHC的敏感性比单一检查更好(P<0.05)。依照绘制的血清AFP以及PIVKA-II浓度水平制作出ROC,能发现联合检测诊断PHC的AUCROC具体值为0.820(P<0.05)。结论PIVKA-II确定针对于原发性肝癌早期诊断价值以及能力明显比AFP要好,PIVKA-II能够被视为独立特意性诊断指标。在此同时联合AFP以及PIVKA-II检测,用于PHC高危群体筛查诊断以及疗效检测,效果优于单一诊断。Objective To analyze the significance of PIVKA-II combined with alpha fetoprotein(AFP)in the early diagnosis of primary liver cancer.Methods From June 2018 to June 2019,90 cases of patients with liver disease were confirmed as subjects after pathological diagnosis in Dongguan People's Hospital.The subjects were divided into the hepatitis group(n=10),the cirrhosis group(n=38),the secondary liver cancer group(n=14),and the primary liver cancer group(PHC)(n=28)according to the disease type.In addition,20 healthy subjects who came to our hospital for examination at the same time were selected as the control group.PIVKA-II and AFP levels in each group were analyzed and compared.Results The levels of AFP and PIVKA-II in serum of PHC group were significantly higher than those of hepatitis group,cirrhosis group,secondary liver cancer group,PHC group and control group(P<0.05).The control group was taken as the reference object,which confirmed that the specificity and sensitivity of PIVKA-II in the diagnosis of PHC were significantly better than those of AFP in the diagnosis of PHC(P<0.05).Combined diagnosis 2[abnormal prothrombin and alpha-fetoprotein positive for combined diagnosis(tandem)]was more sensitive to PHC than a single test(P<0.05).Combined diagnosis 1[combined diagnosis with abnormal prothrombin or positive alpha-fetoprotein positive for Combined diagnosis(parallel)]was more sensitive to PHC than a single test(P<0.05).According to the drawn serum AFP and PIVKAII concentration levels,the AUCROC value of combined detection and diagnosis of PHC was 0.820(P<0.05).Conclusion PIVKA-II was significantly better than AFP in the early diagnosis of HCC,it can be used for screening diagnosis and efficacy test of PHC high-risk groups,and the results obtained are significantly better than the diagnostic value of single application.

关 键 词：原发性肝癌 蛋白质前体 凝血酶原 生物学标记 甲胎蛋白 

分 类 号：R73[医药卫生—肿瘤]