能谱CT与血清LAPTM4B-35、KLF5联合检测对早期原发性肝癌患者的诊断价值  

Diagnostic Value of Energy Spectrum CT Combined with Serum LAPTM4B-35 and KLF5 in Patients with Early-stage Primary Hepatocellular Carcinoma

作　　者：彭郭飞 江鹏[2] 张丹平 宋伟 陈万方 郝泉水 PENG Guofei;JIANG Peng;ZHANG Danping;SONG Wei;CHEN Wanfang;HAO Quanshui(Clinical Laboratory,Huanggang Central Hospital,Huanggang 438021,Hubei,P.R.China;Imaging Department,Huanggang Central Hospital,Huanggang 438021,Hubei,P.R.China;Department of Blood Transfusion,Huanggang Central Hospital,Huanggang 438021,Hubei,P.R.China;Department of Anesthesiology,Huanggang Central Hospital,Huanggang 438021,Hubei,P.R.China)

机构地区：[1]黄冈市中心医院检验科,湖北黄冈438021 [2]黄冈市中心医院影像科,湖北黄冈438021 [3]黄冈市中心医院输血科,湖北黄冈438021 [4]黄冈市中心医院麻醉科,湖北黄冈438021

出　　处：《影像科学与光化学》2024年第6期610-616,共7页Imaging Science and Photochemistry

基　　金：湖北省卫生健康委员会科研项目(WJ2021M084)。

摘　　要：目的:探究能谱计算机断层扫描(CT)与血清溶酶体相关4次跨膜蛋白B-35(LAPTM4B-35)、Kruppel样因子5(KLF5)联合检测对早期原发性肝癌患者的诊断价值。方法:选取本院2021年6月至2023年6月收治的94例原发性肝癌患者作为研究组,94例肝硬化患者作为良性肝病组及医院健康体检者作为对照组,所有受试者均行能谱CT扫描并采用酶联免疫吸附法(ELISA)检测血清LAPTM4B-35和KLF5水平;采用Logistic回归分析和ROC曲线分析原发性肝癌的影响因素和血清LAPTM4B-35和KLF5水平诊断原发性肝癌的诊断效能。结果:能谱CT检测原发性肝癌的准确度、灵敏度和特异度分别为89.89%、90.43%和89.36%。与对照组和良性肝病组相比,研究组血清LAPTM4B-35、KLF5水平异常升高(P<0.05)。多因素Logistic回归分析LAPTM4B-35、KLF5是影响原发性肝癌的危险因素(P<0.05)。根据ROC曲线得知,血清LAPTM4B-35和KLF5诊断原发性肝癌的曲线下面积(AUC)为0.874、0.848,二者联合诊断原发性肝癌的AUC为0.938。LAPTM4B-35和KLF5在原发性肝癌诊断中准确度为85.64%、84.57%,三者联合检测在原发性肝癌诊断中准确度为94.15%。结论:原发性肝癌患者血清LAPTM4B-35、KLF5水平显著升高,能谱CT与血清LAPTM4B-35、KLF5联合检测可提高早期原发性肝癌的诊断价值。Objective:To investigate the diagnostic value of computed tomography(CT)combined with serum lysosome-associated protein transmembrane 4 beta(LAPTM4B-35)and Kruppel-like factor 5(KLF5)in the diagnosis of patients with early-stage primary hepatocellular carcinoma.Methods:94 primary liver cancer patients admitted to our hospital from June 2021 to June 2023(the study group),and 94 cirrhotic patients who underwent energy spectrum CT and enhancement scanning in our hospital(the benign liver disease group).94 patients who underwent physical examination in the same period of time in the hospital(the control group)were selected,and all of them underwent energy spectrum CT scanning.The enzyme-linked immunosorbent assay(ELISA)was used to detect the serum LAPTM4B-35 and KLF5.Logistic regression analysis and ROC curve were used to analyse the influencing factors and the diagnostic performance of serum LAPTM4B-35 and KLF5 in the diagnosis of primary liver cancer.Results:Energy spectrum CT achieved an accuracy,sensitivity and specificity of 89.89%,90.43%and 89.36%,respectively.Serum LAPTM4B-35 and KLF5 levels were abnormally elevated in the study group compared to the control group and benign liver disease group(P<0.05).Multifactorial Logistic regression analyses showed that LAPTM4B-35 and KLF5 were risk factors affecting primary liver cancer(P<0.05).According to the ROC curve,the area under the curve(AUC)for serum LAPTM4B-35 and KLF5 in diagnosing primary liver cancer was 0.874,0.848,respectively,whereas the AUC of the combination of the two markers was 0.938.The accuracy of LAPTM4B-35 and KLF5 alone in the diagnosis of primary liver cancer was 85.64%and 84.57%,respectively.Whereas the accuracy of the three combined tests was 94.15%.Conclusion:Serum LAPTM4B-35 and KLF5 levels were significantly elevated in patients with primary hepatocellular carcinoma,and the combined detection of energy spectrum CT and serum LAPTM4B-35 and KLF5 can improve the diagnostic value of early primary hepatocellular carcinoma.

关 键 词：计算机断层扫描 溶酶体相关4次跨膜蛋白B-35 Kruppel样因子5(KLF5) 原发性肝癌 诊断 

分 类 号：R735.7[医药卫生—肿瘤]