血清PIVKA-Ⅱ在HBV相关肝癌患者中的表达及其与肝功能的相关性  

The correlation between serum PIVKA-II level and liver function in patients with hepatitis B-associated liver cancer

作　　者：孔维菊 任传路 周昱岐 李竞争 何清 袁俊菲 KONG Wei-ju;REN Chuan-lu;ZHOU Yu-qi;LI Jing-zheng;HE Qing;YUAN Jun-fei(Laboratory,904 Hospital of People's Liberation Army Joint Service Support Force,Wuxi 214044,China;Department of Blood Tumor,904 Hospital of People's Liberation Army Joint Service Support Force,Wuxi 214044,China)

机构地区：[1]解放军联勤保障部队第904医院检验科,江苏214044 [2]解放军联勤保障部队第904医院血液肿瘤科,江苏214044

出　　处：《肝脏》2024年第7期794-797,共4页Chinese Hepatology

基　　金：全军医药卫生科研基金课题(15MS033)。

摘　　要：目的观察HBV相关肝癌患者血清异常凝血酶原(PIVKA-Ⅱ)表达水平及肝功能指标并分析其相关性。方法2020年4月—2023年4月解放军联勤保障部队第904医院收治的慢性乙型肝炎患者137例作为慢性乙型肝炎组,另选取同期收治的乙型肝炎肝硬化患者35例作为肝硬化组,同期收治的HBV相关肝癌患者67例作为肝癌组,同期在本院体检健康者51名作为对照组。使用新产业MAGLUMI X8化学发光分析检测血清PIVKA-Ⅱ水平,检测肝功能指标,使用ROCHE cobas6000 E602电化学发光免疫分析仪检测甲胎蛋白(AFP)。以Graphpad prism分析血清PIVKA-Ⅱ水平诊断HBV相关肝癌的价值。结果对照组血清PIVKA-Ⅱ、AFP水平分别为21.0(18.0~27.0)、2.1(1.7~3.3)ng/mL,慢性乙型肝炎组血清PIVKA-Ⅱ、AFP水平分别为22.0(12.0~28.0)、2.3(1.7~3.4)ng/mL,肝硬化组血清PIVKA-Ⅱ、AFP水平分别为21.0(15.0~46.0)、2.5(1.7~4.0)ng/mL,均显著低于肝癌组[PIVKA-Ⅱ、AFP水平分别为61.1(22.0~2021.0)、6.2(2.5~76.8)ng/mL,P<0.05];对照组血清ALT水平为16.0(13.0~26.0)U/L,显著低于慢性乙型肝炎组、肝硬化组、肝癌组[分别为30.0(18.3~44.0)、31.5(25.0~52.3)、30.5(20.0~54.0)U/L,P<0.05];对照组血清AST和GGT水平分别为19.0(16.0~22.0)、24.0(17.0~35.0)U/L,慢性乙型肝炎组血清AST和GGT水平分别为24.0(20.0~31.0)、25.5(17.0~41.7)U/L,均明显低于肝硬化组[分别为31.5(20.0~47.3)、53.5(23.8~99.0)U/L,P<0.05]和肝癌组[分别为31.5(21.5~60.0)、60.0(25.8~135.5)U/L,P<0.05];经Spearman相关性分析,血清PIVKA-Ⅱ与AST、GGT和AFP水平呈正相关(r=0.173,P=0.004;r=0.323,P<0.001;r=0.286,P<0.001);使用Graphpad prism分析,与对照组相较,曲线下面积为0.7523,P<0.05,最佳截断值为41.00 ng/mL,与慢性乙型肝炎组相较,肝癌组PIVKA-Ⅱ曲线下面积为0.7630,最佳截断值为43.50 ng/mL。结论HBV相关肝癌患者血清PIVKA-Ⅱ水平明显高于慢性乙型肝炎患者和乙型肝炎肝硬化患者,诊断HBV相关肝癌具有较高的�Objective The abnormal serum PIVKA-II level and liver function in patients with hepatitis B-associated liver cancer were observed and the correlation was analyzed.Methods A total of 137 chronic hepatitis B patients who were enrolled between April 2020 and April 2023 were taken as the chronic hepatitis B group;35 patients with hepatitis B related cirrhosis admitted during the same period of time were selected as the cirrhosis group;67 patients with hepatitis B-related liver cancer admitted during the same period of time were selected as the liver cancer group;and 51 healthy subjects who underwent physical examination during the same period of time were selected as the control group.The new industry MAGLUMI X8 chemiluminescence analysis was used to detect the serum PIVKA-Ⅱlevel,detect liver function indicators,and ROCHE cobas6000 E602 electrochemiluminescence immunoassay was used to detect alpha fetoprotein(AFP).Graphpad Prism was used to analyze the serum PIVKA-Ⅱlevel in the diagnosis of hepatitis B-related liver cancer.Results The levels of serum PIVKA-Ⅱand AFP were 21.0(18.0~26.0)and 2.1(1.7~3.3)ng/mL respectively in the control group,22.0(12.0~28.0)and 2.3(1.7~3.4)ng/mL in the chronic hepatitis B group,and 21.0(15.0~46.0)and 2.5(1.7~4.0)ng/mL in the cirrhosis group,which were significantly lower than those of 61.7(22.0~2021.0)and 6.2(2.5~76.8)ng/mL in the liver cancer group(P<0.05);The serum ALT level in the control group was 16.0(13.0~26.0)U/L,which was significantly lower than those of 39.0(18.3~44.0)U/L in the chronic hepatitis B group,31.5(25.0~52.3)U/L in cirrhosis group,and 66.0(30.5~54.0)U/L in liver cancer group[P<0.05].The serum AST and GGT levels were 19.0(16.0~22.0)U/L and 24.0(17.0~35.0)U/L respectively in the control group,24.0(20.0~31.0)U/L and 25.0(17.0~41.7)U/L in the chronic hepatitis B group,which were significantly lower than those of 31.5(25.0~52.3)U/L,and 53.5(23.8~99.0)U/L in the cirrhosis group[P<0.05],and 31.5(21.5~60.0)U/L,and 60.0(25.8~135.5)U/L in the liver cancer group,[P<0.05]

关 键 词：慢性乙型肝炎 肝硬化 肝癌 异常凝血酶原 肝功能 

分 类 号：R735.7[医药卫生—肿瘤] R512.62[医药卫生—临床医学]