血清透明质酸、层粘连蛋白、Ⅲ型前胶原N端肽和Ⅳ型胶原辅助诊断原发性肝癌的临床意义分析  

Analysis of clinical significance of serum hyaluronic acid,laminin,amino-terminal peptide of typeⅢprocollagen and collagen typeⅣin auxiliary diagnosis of primary liver cancer

作　　者：王晓晨 罗玲[1] 罗晓红[1] 王英[1] 许柏睿 吴秋菊[1] 张静[1] 禤雪靖 韦婕[1] 段朝晖[1] 林向华[1] WANG Xiao-chen;LUO Ling;LUO Xiao-hong(Department of Clinical Laboratory,Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院检验科,510120

出　　处：《中国实用医药》2024年第13期43-47,共5页China Practical Medicine

摘　　要：目的 分析血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原N端肽(PⅢNP)和Ⅳ型胶原(CⅣ)辅助诊断原发性肝癌的可行性和临床价值。方法 选取82例原发性肝癌患者、33例肝硬化患者及127例健康对照者作为研究对象,分别作为原发性肝癌组、肝硬化组及健康对照组。检测并比较三组血清HA、LN、PⅢNP、CⅣ水平;分析血清HA、LN、PⅢNP、CⅣ的受试者工作特征曲线(ROC曲线)及曲线下面积(AUC);分析血清HA、LN、PⅢNP和CⅣ的诊断界值及诊断效能。结果 原发性肝癌组血清HA 80.32(42.18, 165.50)ng/ml、LN 42.91(31.47, 74.91)ng/ml、PⅢNP 16.15(10.93, 31.33)ng/ml和CⅣ126.00(73.16, 236.60)ng/ml均显著高于健康对照组的26.83(17.25, 40.02)、30.46(25.02, 40.95)、6.38(4.93, 7.86)、48.49(40.24, 57.57)ng/ml(P<0.05);原发性肝癌组血清HA、LN、PⅢNP水平显著低于肝硬化组(P<0.05),原发性肝癌组血清CⅣ水平与肝硬化组比较无统计学差异(P>0.05);肝硬化组血清HA、LN、PⅢNP和CⅣ水平均显著高于健康对照组(P<0.05)。ROC曲线及AUC分析血清HA、LN、PⅢNP和CⅣ的诊断效能显示:血清HA、LN、PⅢNP和CⅣ诊断原发性肝癌的AUC分别为0.8453、0.7195、0.9310和0.8842;血清HA、LN和PⅢNP鉴别原发性肝癌和肝硬化的AUC分别为0.7749、0.6208和0.6384。根据ROC曲线计算原发性肝癌和肝硬化的诊断界值,血清HA+LN+PⅢNP+CⅣ诊断原发性肝癌的灵敏度为92.7%。结论 血清HA、LN、PⅢNP和CⅣ可用于原发性肝癌的辅助诊断,具有重要的临床价值。Objective To analyze the feasibility and clinical values of serum hyaluronic acid(HA),laminin(LN),N-terminal peptide of procollagen typeⅢ(PⅢNP)and collagen typeⅣ(CⅣ)in auxiliary diagnosis of primary liver cancer.Methods 82 patients with primary liver cancer,33 patients with cirrhosis and 127 healthy controls were selected as study subjects,as primary liver cancer group,cirrhosis group and healthy control group respectively.Serum HA,LN,PⅢNP and CⅣlevels were detected and compared among the three groups.Receiver operating characteristic(ROC)curve and area under the ROC curve(AUC)of serum HA,LN,PⅢNP and CⅣwere analyzed,and the diagnostic thresholds and diagnostic efficacy of serum HA,LN,PⅢNP and CⅣwere analyzed.Results Primary liver cancer group had serum HA of 80.32(42.18,165.50)ng/ml,LN of 42.91(31.47,74.91)ng/ml,PⅢNP of 16.15(10.93,31.33)ng/ml,and CⅣof 126.00(73.16,236.60)ng/ml,which were significantly higher than 26.83(17.25,40.02),30.46(25.02,40.95),6.38(4.93,7.86),and 48.49(40.24,57.57)ng/ml in the healthy control group(P<0.05).Serum HA,LN and PⅢNP levels in the primary liver cancer group were significantly lower than those in the cirrhosis group(P<0.05),and there was no statistically significant difference in serum CⅣlevels between the primary liver cancer group and the cirrhosis group(P>0.05).Serum HA,LN,PⅢNP and CⅣlevels in the cirrhosis group were significantly higher than those in the healthy control group(P<0.05).The ROC curves and AUC were used to analyze the diagnostic efficacy of serum HA,LN,PⅢNP and CⅣ:the AUC of serum HA,LN,PⅢNP and CⅣin diagnosis of primary liver cancer were 0.8453,0.7195,0.9310 and 0.8842 respectively;the AUC of serum HA,LN and PⅢNP in differentiating primary liver cancer from cirrhosis were 0.7749,0.6208 and 0.6384 respectively.The sensitivity of serum HA+LN+PⅢNP+CⅣassay for primary liver cancer was 92.7%when the diagnostic thresholds of primary liver cancer and cirrhosis were calculated based on the ROC curve.Conclusion Serum HA,LN,P

关 键 词：透明质酸 层粘连蛋白 Ⅲ型前胶原N端肽 Ⅳ型胶原 原发性肝癌 

分 类 号：R735.7[医药卫生—肿瘤]