纤维蛋白原/前白蛋白比值、γ-谷氨酰转肽酶/血小板比值在甲胎蛋白阴性肝细胞癌中的应用价值  

Diagnostic value of fibrinogen/prealbumin ratio and γ-glutamyl transpeptidase/platelet ratio in alpha-fetoprotein-negative hepatocellular carcinoma

作　　者：王蔚[1] 李慧艳[1] 刘华[1] WANG Wei;LI Hui-yan;LIU Hua(Department of Medical-Oncology,Hainan General Hospital,Hainan 570103,China)

机构地区：[1]海南省人民医院肿瘤内科,海口570103

出　　处：《肝脏》2021年第3期270-272,280,共4页Chinese Hepatology

基　　金：海南省自然科学基金面上项目(817332)。

摘　　要：目的评估纤维蛋白原/前白蛋白比值(FPR)、γ-谷氨酰转肽酶/血小板比值(GPR)在甲胎蛋白阴性肝细胞癌(AFP-N HCC)患者中的应用价值。方法 2018年3月至2020年3月AFP-N HCC患者(AFP-N HCC组)80例(男58例、女22例),年龄(50.2±9.8)岁。另选取同期健康体检患者(健康组)100例(男60例、女40例),平均年龄(49.8±6.2)岁。Logistic回归分析确定影响AFP-N HCC独立预测因素;ROC曲线确定诊断AFP-N HCC的截断点,计算诊断效能。结果 AFP-N HCC组、健康组PLT、Hb、FIB、PA、ALT、AST、TBil、γ-GT、FPR及GPR具有显著性差异(P<0.05)。以患者是否存在AFP-N HCC为分类标准,将PLT、Hb、FIB、PA、ALT、AST、TBil、γ-GT、FPR及GPR纳入多因素Logistic回归分析。结果显示,ALT、FPR、GPR是评估是否存在AFP-N HCC的独立影响因素(P<0.05)。FPR诊断AFP-N HCC时AUC及95%CI、截断点、敏感度及特异度分别为0.94(0.90~0.96)、11.60、86.5%及88.4%;GPR诊断AFP-N HCC时AUC及95%CI、截断点、敏感度及特异度分别为0.89(0.85~0.92)、0.21、68.4%及94.8%;FPR联合GPR诊断AFPN HCC时AUC及95%CI、敏感度及特异度分别为0.97(0.95~0.99)、91.0%及96.2%。结论 FPR、GPR可作为AFPN HCC诊断的生物学指标,两者联合诊断时效能优异。Objective To evaluate the value of fibrinogen/prealbumin ratio(FPR)and γ-glutamyl transpeptidase/platelet ratio(GPR)in alpha-fetoprotein-negative hepatocellular carcinoma(AFP-N HCC).Methods From March 2018 to March 2020,there were 80 AFP-N HCC patients(58 males and 22 females)with an average age of(50.2 ± 9.8)years,and 100 patients undergoing physical examination(60 males and 40 females)with an average age of(49.8 ± 6.2)years enrolled in the study.The independent predictive factors of AFP-N HCC were analyzed by Logistic regression.Cut-off points for diagnosing AFP-N HCC were determined by receiver operating characteristic(ROC)curve,and the diagnostic efficiency was calculated.Results There were significant differences in platelet,hemoglobin,fibrinogen,phosphatidic acid,alanine transaminase(ALT),aspartate transaminase,total bilirubin,gamma-glutamyl transpeptidase,FPR and GPR between AFP-N HCC group and healthy group(P<0.05).Logistic regression analysis showed that ALT,FPR and GPR were independent factors for AFP-N HCC(P<0.05).The cut-off value of FPR for diagnosing AFP-N HCC was 11.60,with area under the curve(AUC)[95% confidence interval(CI)]of 0.94(0.90-0.96),sensitivity of 86.5%,and specificity of 88.4%.The cut-off value of GPR for diagnosing AFP-N HCC was 0.21,with AUC(95% CI)of 0.89(0.85-0.92),sensitivity of 68.4% and specificity of 94.8%.Combining FPR and GPR,the AUC(95% CI),sensitivity and specificity were 0.97(0.95-0.99),91.0% and 96.2%,respectively.Conclusion FPR and GPR can be used for the diagnosis of AFP-N HCC.The combination of FPR and GPR has better diagnostic value.

关 键 词：甲胎蛋白阴性肝细胞癌 纤维蛋白原/前白蛋白比值 γ-谷氨酰转肽酶/血小板比值 

分 类 号：R735.7[医药卫生—肿瘤]