凝血4项指标及肿瘤标志物诊断乙型肝炎相关肝癌的价值及与病理分期的相关性  

The Value of Four Coagulation Indexes and Tumor Markers in The Diagnosis of Hepatitis B-Related Hepatocellular Carcinoma and Their Correlation with Pathological Stage

作　　者：陈梦丽 Chen Meng-li(Nanyang Central Hospital,Laboratory Department,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市中心医院检验科,河南南阳473000

出　　处：《罕少疾病杂志》2023年第7期61-62,65,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨凝血4项指标及肿瘤标志物诊断乙型肝炎相关肝癌的价值及与病理分期的相关性。方法选取2018年9月~2020年9月我院乙型肝炎相关肝癌患者196例为观察组,并以1:1配比选取同期良性肝病196例为对照组,均检测凝血4项[部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(Fib)]及肿瘤标志物[甲胎蛋白(AFP)、血管内皮生长因子(VEGF)、岩藻糖苷酶(AFU)]。记录凝血4项指标(APTT、PT、TT、Fib)、凝血4项检测阳性率、肿瘤标志物检测(AFP、VEGF、AFU)、观察组不同BCLC分期(0~A期、B~D期)肿瘤标志物水平、诊断效能及不同BCLC分期检测阳性率。结果观察组APTT、PT、TT水平较对照组高,Fib水平较对照组低(P<0.05);观察组APTT、PT、Fib、TT检测阳性率较对照组高(P<0.05);观察组VEGF、AFP、AFU指标水平较对照组高(P<0.05);观察组VEGF、AFP、AFU指标在B~D期的检测阳性率)较0~A期高(P<0.05);凝血四项联合肿瘤标志物诊断的特异度为92.86%,灵敏度为84.18%均较单项检测的灵敏度和特异性高(P<0.05);血清检测阳性率和BCLC分期成正相关。结论乙型肝炎相关肝癌患者凝血功能和肿瘤标志物异常表达,且临床诊断乙型肝炎相关肝癌阳性率高,具备较好的诊断效能,BCLC分期越高,检测乙型肝炎相关肝癌阳性率越高,可为疾病诊断提供科学依据。Objective To investigate the value of four coagulation indexes and tumor markers in the diagnosis of hepatitis B-related liver cancer and their correlation with pathological stage.Methods 196 patients with hepatitis B related liver cancer in our hospital from September 2018 to September 2020 were selected as the observation group,and 196 patients with benign liver disease during the same period were selected as the control group with a 1:1 ratio.All 4 items of coagulation(APTT,PT,TT,Fib)and tumor markers(AFP,VEGF,AFU)were detected.The four coagulation indexes(APTT,PT,TT,Fib),the positive rate of four coagulation tests,the detection of tumor markers(AFP,VEGF,AFU),the levels of tumor markers in different BCLC stages(0-A,B-D),the diagnostic efficacy and the positive rate of different BCLC stages were recorded.Results The levels of APTT,PT and TT in the observation group were higher than those in the control group,and the level of Fib was lower than that in the control group(P<0.05).The positive rates of APTT,PT,Fib and TT in the observation group were higher than those in the control group(P<0.05).The levels of VEGF,AFP and AFU in the observation group were higher than those in the control group(P<0.05).The positive rates of VEGF,AFP and AFU in B-D stage of observation group were higher than those in 0-A stage(P<0.05).The specificity and sensitivity of coagulation combined with tumor markers were 92.86%and 84.18%,which were higher than those of single detection(P<0.05).The positive rate of serum test was positively correlated with BCLC stage.Conclusions The abnormal expression of coagulation function and tumor markers in patients with hepatitis B-related liver cancer,and the positive rate of clinical diagnosis of hepatitis B-related liver cancer is high,which has a good diagnostic efficiency.The higher the BCLC stage,the higher the positive rate of detection of hepatitis B-related liver cancer,which can provide a scientific basis for disease diagnosis.

关 键 词：乙型肝炎 肝癌 凝血4项 肿瘤标志物 

分 类 号：R446.1[医药卫生—诊断学]