彩色多普勒超声结合CEA、AFU、AFP检测对肝恶性肿瘤的诊断价值  

The diagnostic value of color Doppler ultrasonography combined with CEA,AFU,and AFP detection in hepatic malignant tumors

作　　者：王珏 吕永锋 焦琳 祝丽娜 WANG Jue;LV Yongfeng;JIAO Lin;ZHU Lina(Department of Ultrasound,Chengyang District Peoples Hospital,Qingdao,Shandong,China,266109;Department of Functional Examination,Qingdao Haici Hospital Affiliated to Qingdao University(Qingdao Tra-ditional Chinese Medicine Hospital),Qingdao,Shandong,China,266033)

机构地区：[1]青岛市城阳区人民医院超声科,山东青岛266109 [2]青岛大学附属青岛市海慈医院(青岛市中医医院)功能检查科,山东青岛266033

出　　处：《分子诊断与治疗杂志》2024年第4期756-759,764,共5页Journal of Molecular Diagnostics and Therapy

基　　金：山东省科技发展计划项目(2023WS0303)。

摘　　要：目的 分析彩色多普勒超声(CDFI)结合癌胚抗原(CEA)、α-L-岩藻糖苷酶(AFU)、甲胎蛋白(AFP)检测对肝恶性肿瘤的诊断价值。方法 选取2021年5月至2023年8月青岛市城阳区人民医院收治的肝恶性肿瘤141例(肝恶性肿瘤组),另选取同期本院收治的经临床确诊的良性肝病患者138例(良性肝病组)、健康体检者133名(健康体检组)。以病理诊断为标准,分析CDFI对肝恶性肿瘤的诊断结果。比较不同组别、肝恶性肿瘤组不同疾病类型的RI、Vmax、CEA、AFU、AFP水平。采用Kappa一致性检验评估CDFI、CEA、AFU、AFP与病理检查诊断的一致性。绘制ROC曲线分析CDFI、CEA、AFU、AFP单一及联合检测肝恶性肿瘤的诊断价值。结果 以病理诊断为标准,CDFI共检出118例(83.68%)肝恶性肿瘤,其中原发性肝癌73例、继发性肝癌45例;原发性肝癌、继发性肝癌均以少血供为主要特征。RI、Vmax、CEA、AFU、AFP水平:肝恶性肿瘤组>良性肝病组>健康体检组,差异均具有统计学意义(P<0.05)。原发性肝癌RI、Vmax、CEA、AFU、AFP水平均高于继发性肝癌,差异具有统计学意义(P<0.05)。CDFI、CEA、AFU、AFP联合检测与病理诊断Kappa值为0.766,灵敏度、特异度、AUC(95%CI)分别为92.55%、91.18%、0.762(0.637~0.814),与CDFI、CEA、AFU、AFP单一检测Kappa值、灵敏度、特异度、AUC(95%CI)比较,差异具有统计学意义(P<0.05)。结论 CDFI、CEA、AFU及AFP检测对肝恶性肿瘤诊断均有一定价值,上述指标相互结合在肝恶性肿瘤诊断具有确切的互补作用,可全面、准确判定肝恶性肿瘤,提高肝恶性肿瘤诊断的可靠性。Objective To analyze the diagnostic value of color Doppler ultrasonography(CDFI)combined with CEA,α⁃L⁃fucosidase(AFU)and alpha⁃fetoprotein(AFP)in hepatic malignant tumors.Meth⁃ods A total of 141 patients with liver malignant tumors admitted to Chengyang District Peoples Hospital of Qingdao from May 2021 to August 2023 were selected for the liver malignant tumor group,and 138 patients with clinically confirmed benign liver disease admitted to our hospital during the same period were selected for the benign liver disease group,and 133 healthy physical examination subjects were selected for the healthy phys⁃ical examination group.Based on pathological diagnosis,the diagnostic results of CDFI on hepatic malignant tu⁃mors were analyzed.The levels of RI,Vmax,CEA,AFU and AFP were compared in different groups The diagnostic results of CDFI for hepatic malignant tumors were analyzed based on pathological diagnosis.The levels of RI,Vmax,CEA,AFU and AFP were compared among different groups and disease types.The consistency of CDFI,CEA,AFU,AFP and pathologic diagnosis was evaluated using the Kappa consistency test.Additional⁃ly,the diagnostic value of CDFI,CEA,AFU,and AFP in the single and combined detection of liver malignant tumors was analyzed using ROC curve analysis.Results Based on the pathological diagnosis,CDFI detected a total of 118 cases(83.68%)of liver malignancies,including 73 cases of primary liver cancer and 45 cases of secondary liver cancer.Both types of liver cancer were mainly characterized by low blood supply.The levels of RI,Vmax,CEA,AFU and AFP were as follows:the liver cancer group>benign liver disease group>healthy physical examination group,with statistically significant differences(P<0.05).The levels of RI,Vmax,CEA,AFU,and AFP in primary liver cancer were statistically higher than those in secondary liver cancer(P<0.05).The Kappa value of CDFI,CEA,AFU,and AFP combined with pathological diagnosis was 0.766.The sensitiv⁃ity,specificity,and AUC(95%CI)were 92.55%,91.18%and 0.762(0.637~0

关 键 词：彩色多普勒超声 CEA AFU AFP 肝恶性肿瘤 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]