血清甲胎蛋白异质体L3、超敏C反应蛋白及乙肝病毒载量在诊断乙肝肝硬化与肝癌中的价值  

The Value of AFP-L3,Hs-CRP and HBV-DNA in the Diagnosis of Hepatitis B Cirrhosis and Liver Cancer

作　　者：刘芳[1] 季良[1] 陈男男 姜海燕[1] 陈志赫 杜宁[2] LIU Fang;JI Liang;CHEN Nan-nan(Department of Infectious Diseases,Jiamusi Central Hospital,Jiamusi,Heilongjiang,154002,China)

机构地区：[1]佳木斯市中心医院感染科,黑龙江佳木斯154002 [2]佳木斯大学公共卫生学院,黑龙江佳木斯154002

出　　处：《黑龙江医学》2021年第9期984-986,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨血清甲胎蛋白异质体L3(AFP-L3)、超敏C反应蛋白(hs-CRP)及乙肝病毒载量(HBV-DNA)在诊断乙肝肝硬化与乙肝相关性肝癌中的价值。方法:选取佳木斯市中心医院确诊的80例乙肝肝硬化患者(肝硬化组)、80例乙肝相关性肝癌患者作为肝癌组;检测对比两组的AFP-L3、hs-CRP及HBV-DNA水平,绘制受试者工作曲线分析在具有最佳诊断指数的情况下三项指标的诊断价值。结果:肝硬化组患者的AFP-L3、hs-CRP及HBV-DNA水平显著低于肝癌组患者,差异具有统计学意义(P<0.05);血清AFP-L3水平鉴别诊断肝癌、肝硬化的灵敏度为96.13%、特异度为87.04%、ROC曲线下面积AUC值为0.928;hs-CRP检测鉴别诊断肝癌、肝硬化的灵敏度为88.14%、特异度为81.17%、ROC曲线下面积AUC值为0.852;HBV-DNA检测鉴别诊断肝癌、肝硬化的灵敏度为54.27%、特异度为76.84%、ROC曲线下面积AUC值为0.694。结论:肝癌患者的AFP-L3、hs-CRP及HBV-DNA水平较肝硬化患者升高更加明显,根据上述三项指标在乙肝肝硬化、乙肝相关肝癌的鉴别诊断中有一定的价值。Objective: To investigate the value of serum alpha-fetoprotein heterogeneous L3(AFP-L3), high-sensitivity C-re-active protein(hs-CRP) and hepatitis B virus load(HBV-DNA) in the diagnosis of hepatitis B cirrhosis and hepatitis B-relatedliver cancer. Methods: 80 patients with hepatitis B cirrhosis were selected as cirrhosis group and 80 patients with hepatitis B-re-lated liver cancer were selected as the liver cancer group. The AFP-L3, hs-CRP and HBV-DNA levels were compared betweenthe two groups. Receiver operating curve was drawn to analyze the diagnostic value of the three indicators with the best diagnosticindex. Results: The levels of AFP-L3, hs-CRP and HBV-DNA in patients with cirrhosis were significantly lower than those in pa-tients with liver cancer(P<0.05). The sensitivity of serum AFP-L3 level in differential diagnosis of liver cancer and cirrhosis was96.13.%, specificity was 87.04%, area under the ROC curve AUC value was 0.928. The sensitivity of hs-CRP detection for differ-ential diagnosis of liver cancer group and cirrhosis group was 88.14%, specificity was 81.17%, and area under the ROC curve AUCwas 0.852. The sensitivity of HBV-DNA detection for differential diagnosis of liver cancer and cirrhosis was 54.27%, the specifici-ty was 76.84%, and the area under the ROC curve was AUC of 0.694. Conclusion: The levels of AFP-L3, hs-CRP and HBV-DNA in patients with liver cancer are more obvious than those in patients with liver cirrhosis. According to the above three indica-tors, it has certain value in the differential diagnosis of hepatitis B cirrhosis and hepatitis B related liver cancer.

关 键 词：甲胎蛋白异质体L3 超敏C反应蛋白 乙肝病毒载量 乙肝肝硬化 乙肝相关性肝癌 

分 类 号：R473.51[医药卫生—护理学]