血清PIVKA-Ⅱ、AFP、AFP-L3%联合检测在原发性肝癌诊断中的应用价值  

Application value of serum PIVKA-Ⅱ,AFP and AFP-L3% combined detection in the diagnosis of primary liver cancer

作　　者：余小龙[1] 罗晓莉[1] 金善丰[1] 陈燕[1] YU Xiao-long;LUO Xiao-li;JIN Shan-feng(Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014)

机构地区：[1]福建医科大学肿瘤临床学院,福建省肿瘤医院,350014

出　　处：《中国现代药物应用》2023年第10期63-66,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 研究原发性肝癌诊断中血清异常凝血酶原(PIVKA-Ⅱ)、甲胎蛋白(AFP)、甲胎蛋白异质体比率(AFP-L3%)联合检测的应用价值。方法 选取150例健康体检者、100例慢性乙型肝炎(乙肝)患者、87例原发性肝癌患者,分别设为对照组、肝炎组、肝癌组。所有研究对象均进行PIVKA-Ⅱ、AFP、AFP-L3检测,对比三组肿瘤标志物的检测结果及阳性检出率,肿瘤标志物单项检测与联合检测的诊断效能。结果 对照组PIVKA-Ⅱ为(2.76±0.41)mAU/ml、AFP为(3.05±0.64)μg/L、AFP-L3%为(3.01±0.52)%;肝炎组PIVKA-Ⅱ为(14.32±2.18)mAU/ml、AFP为(18.67±2.11)μg/L、AFP-L3%为(10.14±2.13)%;肝癌组PIVKA-Ⅱ为(9750.59±17934.97)mAU/ml、AFP为(23865.92±69102.40)μg/L、AFP-L3%为(16.72±17.66)%。对照组、肝炎组、肝癌组的PIVKA-Ⅱ、AFP、AFP-L3%呈升高趋势,且各组间对比,差异有统计学意义(P<0.05)。肝癌组PIVKA-Ⅱ、AFP、AFP-L3%单项检测阳性检出率与联合检测阳性检出率分别为73.56%、65.52%、62.07%、87.36%,均高于对照组的0、0、0、0与肝炎组的4.00%、8.00%、10.00%、6.00%,且肝炎组高于对照组,差异有统计学意义(P<0.05)。在原发性肝癌中,PIVKA-Ⅱ单项检测敏感度为73.56%、特异度为96.00%、准确性为85.56%、阳性预测值为94.12%、阴性预测值为80.67%;AFP单项检测敏感度为65.52%、特异度为92.00%、准确性为79.68%、阳性预测值为87.69%、阴性预测值为75.41%;AFP-L3%单项检测敏感度为62.07%、特异度为90.00%、准确性为77.01%、阳性预测值为84.38%、阴性预测值为73.17%;PIVKA-Ⅱ、AFP、AFP-L3%联合检测敏感度为91.95%、特异度为98.00%、准确性为95.19%、阳性预测值为97.56%、阴性预测值为93.33%。PIVKA-Ⅱ、AFP、AFP-L3%联合检测的敏感度、准确性以及阴性预测值均高于PIVKA-Ⅱ、AFP、AFP-L3%单项检测,特异度高于AFP-L3%单项检测,阳性预测值高于AFP、AFP-L3%单项检测,差异有统计学意义(P<0.05)。结论 联合检测�Objective To study the application value of serum protein induced by vitamin K antagonist-Ⅱ(PIVKA-Ⅱ),alpha-fetoprotein(AFP)and alpha-fetoprotein-L3 ratio(AFP-L3%)combined detection in the diagnosis of primary liver cancer.Methods 150 healthy checkups were selected as the control group,100 patients with chronic hepatitis B as hepatitis group,and 87 patients with primary liver cancer as liver cancer group.All study subjects were tested for PIVKA-Ⅱ,AFP,and AFP-L3%.The detection results and positive detection rate of tumor markers of the three groups were compared,as well as the diagnostic efficacy of single and combined detection of tumor markers.Results The control group had PIVKA-Ⅱof(2.76±0.41)mAU/ml,AFP of(3.05±0.64)μg/L,AFP-L3%of(3.01±0.52)%;the hepatitis group had PIVKA-Ⅱof(14.32±2.18)mAU/ml,AFP of(18.67±2.11)μg/L,AFP-L3%of(10.14±2.13)%;the liver cancer group had PIVKA-Ⅱof(9750.59±17934.97)mAU/ml,AFP of(23865.92±69102.40)μg/L,AFP-L3%of(16.72±17.66)%.PIVKA-Ⅱ,AFP and AFP-L3%of control group,hepatitis group and liver cancer group were increased,and the difference was statistically significant among all groups(P<0.05).In the liver cancer group,the positive detection rates of PIVKA-Ⅱ,AFP,and AFP-L3%alone and in combination were 73.56%,65.52%,62.07%,and 87.36%,which were higher than those of 0,0,0,0 in the control group,and 4.00%,8.00%,10.00%,and 6.00%in the hepatitis group;the hepatitis group was higher than the control group;the differences were statistically significant(P<0.05).In primary liver cancer,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PIVKA-Ⅱwere 73.56%,96.00%,85.56%,94.12%and 80.67%;the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of AFP were 65.52%,92.00%and 79.68%;the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of AFP-L3%were 62.07%,90.00%,77.01%,84.38%and 73.17%;the sensitivity,specificity,accuracy,positive predictive value and nega

关 键 词：原发性肝癌 异常凝血酶原 甲胎蛋白 甲胎蛋白异质体比率 诊断价值 

分 类 号：R735.7[医药卫生—肿瘤]