血清异常凝血酶原联合甲胎蛋白检测在原发性肝癌诊断中的应用价值  

Application value of serum abnormal prothrombin combined with alpha fetoprotein detection in diagnosis of primary liver cancer

作　　者：寇天 郝振伟 陈曦[2] KOU Tian;HAO Zhenwei;CHEN Xi(Department of Clinical Laboratory of Jiamusi Hospital of Traditional Chinese Medicine,Jiamusi 154002 Heilongjiang,China;The Central Hospital of Jiamusi City,Jiamusi 154002 Heilongjiang,China)

机构地区：[1]佳木斯市中医医院检验科,黑龙江佳木斯154002 [2]佳木斯市中心医院,黑龙江佳木斯154002

出　　处：《中国民康医学》2022年第23期134-137,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨血清异常凝血酶原(PIVKA-Ⅱ)联合甲胎蛋白(AFP)检测在原发性肝癌(PLC)诊断中的应用价值。方法:选取2019年3月至2021年9月佳木斯中医医院收治的192例患者为研究对象,其中PLC患者48例,纳入PLC组,慢性乙型肝炎病毒(HBV)感染者48例,纳入HBV组,慢性丙型肝炎病毒(HCV)感染者48例,纳入HCV组,肝硬化(LC)患者48例,纳入LC组,另选取同期52名健康体检者为健康组,比较四组AFP、PIVKA-Ⅱ水平,不同病理特征PLC患者血清AFP、PIVKA-Ⅱ水平,并绘制受试者工作曲线(ROC),分析AFP、PIVKA-Ⅱ单项及联合检测在PLC诊断中的价值。结果:PLC组AFP、PIVKA-Ⅱ水平高于健康组、HBV组、LC组、HCV组,差异均有统计学意义(P<0.05);不同肿瘤直径、巴塞罗那临床肝癌(BCLC)分期和肿瘤细胞分化程度的PLC患者血清AFP、PIVKA-Ⅱ水平比较,差异均有统计学意义(P<0.05);不同肿瘤结节PLC患者血清AFP、PIVKA-Ⅱ水平比较,差异无统计学意义(P>0.05);ROC曲线结果显示,AFP、PIVKA-Ⅱ单项及联合检测的AUC分别为0.883、0.923、0.962,联合检测诊断价值最高。结论:血清PIVKA-Ⅱ联合AFP检测在PLC诊断中具有较高应用价值,临床可根据其水平变化评估肿瘤直径、分期、肿瘤细胞分化程度。Objective:To investigate application value of serum abnormal prothrombin(PIVKA-II)combined with alpha-fetoprotein(AFP)in the diagnosis of primary liver cancer(PLC).Methods:92 patients admitted to Jiamusi hospital of traditional Chinese medicine from March 2019 to September 2021 were selected as the research objects.Among them,48 patients with PLC were included in PLC group,48 patients with chronic hepatitis B virus(HBV)infection were included in HBV group,48 patients with chronic hepatitis C virus(HCV)infection were included in t HCV group,and 48 patients with cirrhosis(LC)were included in LC group.Another 52 healthy subjects were selected as healthy group.The levels of AFP and PIVKA-II as well as the serum AFP and PIVKA-II levels in the PLC patients with different pathological characteristics were compared among the four groups.ROC curve was plotted to analyze the value of single and combined detections of AFP and PIVKA-II in the diagnosis of PLC.Results:The levels of AFP and PIVKA-II in PLC group were significantly higher than those in healthy group,HBV group,LC group and HCV group(P<0.05).There were significant differences in the serum AFP and PIVKA-II levels among the PLC patients with different tumor diameter,Barcelona clinical liver cancer(BCLC)stage and tumor cell differentiation(P<0.05).There were no significant differences in the serum AFP and PIVKA-II levels among the PLC patients with different tumor nodules(P>0.05).ROC curve showed that the AUCs of single AFP detection,single PIVKA-II detection and combined detection were 0.883,0.923 and 0.962,separately,and the diagnostic value of combined detection was the highest.Conclusions:The serum PIVKA-II combined with AFP detection has high application value in the diagnosis of PLC.Clinically,the tumor diameter,the stage and the tumor cell differentiation should be evaluated according to its level changes.

关 键 词：原发性肝癌 异常凝血酶原 甲胎蛋白 检测 诊断价值 

分 类 号：R735.7[医药卫生—肿瘤]