血清PIVKA-Ⅱ、AFP、GGT及ALP检测对原发性肝癌的诊断价值  

The diagnostic value of serum PIVKA- Ⅱ , AFP, GGT and ALP in primary hepatic carcinoma

作　　者：刘嘉清 王琴[1] 周廷栋[1] 周强[1] LIU Jia-qing;WANG Qin;ZHOU Ting-dong(The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,Anhui)

机构地区：[1]安徽医科大学第二附属医院检验科,安徽合肥230601

出　　处：《安徽医专学报》2024年第2期94-96,共3页Journal of Anhui Medical College

基　　金：国家自然科学基金项目(编号:81902056)。

摘　　要：目的:探究血清异常凝血酶原(PIVKA-Ⅱ)、甲胎蛋白(AFP)、γ-谷氨酰转移酶(GGT)与碱性磷酸酶(ALP)检测对原发性肝癌(PHC)的诊断价值。方法:选取41例初治PHC患者为PHC组,39例肝硬化患者为肝硬化组,40例健康体检者为健康对照组。对各组血清PIVKA-Ⅱ、AFP、GGT及ALP水平进行定量检测,并比较各组间水平,同时分析各指标单独和联合检测PHC时的灵敏度、特异度及受试者工作特征曲线(ROC)下面积(AUC)。结果:PHC组患者血清PIVKA-Ⅱ、AFP、GGT及ALP均高于肝硬化组和健康对照组(P<0.05);PIVKA-Ⅱ、AFP、GGT和ALP单项检测的AUC分别为0.839、0.834、0.837和0.799。联合检测AUC均高于各指标单项检测AUC,其中PIVKA-Ⅱ、AFP、GGT及ALP联合检测的AUC最高(0.939),敏感度最高(90.24%),PIVKA-Ⅱ与AFP联合检测的特异度最高(97.47%)。结论:血清PIVKA-Ⅱ、AFP、GGT及ALP联合检测可提高对PHC的诊断效能,四者联合有利于PHC的早期筛查与诊断。Objective:To explore the diagnostic value of combined use of protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ),alpha-fetoprotein(AFP),γ-glutamyl transpeptidase(GGT)and alkaline phosphatase(ALP)in primary hepatic carcinoma(PHC).Methods:41 patients with initial PHC were selected as PHC group,39 patients with liver cirrhosis as cirrhosis group,and 40 healthy physical examination subjects as healthy control group.The levels of serum PIVKA-Ⅱ,AFP,GGT and ALP in each group were quantitatively detected and compared among the groups.The sensitivity,specificity and area under the curve(AUC)of each index alone and in combination were analyzed,and the receiver operating characteristic curve(ROC)was plotted.Results:The serum levels of PIVKA-Ⅱ,AFP,GGT and ALP in PHC group were higher than those in cirrhosis group and healthy control group(P<0.05);The AUC of PIVKA-Ⅱ,AFP,GGT and ALP were 0.839,0.834,0.837 and 0.799,respectively.The AUC of combined detection was higher than that of each index alone.The AUC and the sensitivity of combined detection of PIVKA-Ⅱ,AFP,GGT and ALP were highest(0.939,90.24%),and the specificity of combined detection of PIVKA-Ⅱand AFP was highest among all the detection groups(97.47%).Conclusions:The combined detection of serum PIVKA-Ⅱ,AFP,GGT and ALP can improve the diagnostic efficiency of PHC,and the combination of the four is beneficial to the early screening and diagnosis of PHC.

关 键 词：原发性肝癌 PIVKA-Ⅱ AFP GGT ALP 联合检测 

分 类 号：R735.7[医药卫生—肿瘤]