凝血功能5项联合甲胎蛋白在原发性肝癌诊断中的价值  

The value of five items of coagulation function combined with alpha-fetoprotein in the diagnosis of primary liver cancer

作　　者：严蓓蓓[1] 潘曹敏[2] YAN Beibei;PAN Caomin(Department of Clinical Laboratory of Taizhou Fourth People’s Hospital,Taizhou 225300,China;Department of Clinical Laboratory of Nanjing Hospital of Integrated Traditional Chineseand Western Medicine,Nanjing210014,China)

机构地区：[1]泰州市第四人民医院检验科,江苏泰州225300 [2]南京市中西医结合医院检验科,江苏南京210014

出　　处：《中国实验诊断学》2025年第1期41-45,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析凝血功能5项联合甲胎蛋白在原发性肝癌诊断中的价值。方法选2019年1月到2021年1月泰州市第四人民医院收治的原发性肝癌患者110例为研究组,另选取同期体检志愿者60例为对照组。检测两组凝血功能5项、甲胎蛋白水平。结果与对照组相比,研究组凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)较长,D-二聚体、甲胎蛋白(AFP)水平较高,纤维蛋白原(FIB)水平较低(P<0.05)。原发性肝癌Ⅰ~Ⅱ期、高分化、未发生淋巴结转移、肿瘤直径<4、单个结节、未出现静脉侵犯患者D-二聚体、TT、PT、APTT、AFP均低于Ⅲ~Ⅳ期、中低分化、淋巴结转移、肿瘤直径≧4、多发结节、出现静脉侵犯患者,FIB则相反(均P<0.05)。将性别、年龄等因素控制后,D-二聚体、TT、PT、APTT、AFP与临床分期、组织分化程度、淋巴结转移、肿瘤直径、肿瘤部位特点、静脉侵犯呈正相关,FIB与临床分期、组织分化程度、淋巴结转移、肿瘤直径、肿瘤部位特点、静脉侵犯呈负相关(P<0.05)。6项联合对原发性肝癌的诊断价值高于D-二聚体、TT、PT、APTT、FIB、AFP蛋白单项检测(P<0.05)。结论原发性肝癌患者TT、PT、APTT较长,D-二聚体、AFP水平较高,FIB水平较低,且D-二聚体、TT、PT、APTT、AFP表达情况与临床分期、组织分化程度、淋巴结转移、肿瘤直径、肿瘤部位特点、静脉侵犯相关,联合检测对原发性肝癌诊断价值较高。Objective To analyze the value of five items of coagulation function combined with alpha-fetoprotein in the diagnosis of primary liver cancer.Methods A total of 110patients with primary liver cancer who were treated in our hospital from January 2019to January 2021were selected as the research group,and 60volunteers who underwent physical examination in our hospital were selected as the control group.The five items of coagulation function and the level of alpha-fetoprotein were detected in the two groups.Results Compared with the control group,the study group had higher levels of D-dimer and AFP,thrombin time(TT),procoagulation time(PT),activated partial coagulation time(APTT)were longger,and fibrinogen(FIB)were lower(P<0.05).Primary liver cancer I-stage,high differentiation,no lymph node metastasis,tumor diameter<4,single nodules,no venous invasion,TT,PT,APTT,alpha-stage,low differentiation,lymph node metastasis,tumor diameter 4,multiple nodules,venous invasion,FIB above-stage,low differentiation,lymph node metastasis,tumor diameter 4,multiple nodules,and patients with venous invasion(all P<0.05).After controlling factors such as sex and age,D-dimer,TT,PT,APTT,AFP were positively associated with clinical stage,tissue differentiation,lymph node metastasis,tumor diameter,tumor site characteristics,venous invasion,FIB and clinical stage,tissue differentiation,lymph node metastasis,tumor diameter,tumor site characteristics,and venous invasion(P<0.05).The diagnostic value of the six combinations was higher for primary liver cancer than for the single test of Ddimer,TT,PTT,APTT,FIB,and alpha-fetoprotein(P<0.05).Conclusion Patients with primary liver cancer D-dimer,TT,PT,APTT,methyl fetal protein is higher levels,FIB level is low,and,D-dimer,TT,PT,APTT,methyl fetal protein expression and clinical stage,tissue differentiation,lymph node metastasis,tumor diameter,tumor site characteristics,venous invasion,combined detection of primary liver cancer diagnosis value is higher.

关 键 词：原发性肝癌 甲胎蛋白 凝血功能5项 临床分期 

分 类 号：R73[医药卫生—肿瘤]