AFP、AFP-L3/AFP联合超声造影在鉴别肝硬化和肝癌的诊断效能评估  

Evaluation of the Diagnostic Efficacy of AFP,AFP-L3/AFP Combined Ultrasonography in Differentiating Cirrhosis and Hepatocellular Carcinoma

作　　者：张丽[1] 郭二芳 孟亦真 范智慧 李晶晶 郝玉静 张冬艳[1] ZHANG Li;GUO Erfang;MENG Yizhen;FAN Zhihui;LI Jingjing;HAO Yujing;ZHANG Dongyan(Ultrasound Department,Kailuan General Hospital,Tangshan,Hebei 063001,China;Ultrasound Department,North China University of Science and Technology Affiliated Hospital,Tangshan,Hebei 063001,China)

机构地区：[1]开滦总医院超声科,河北唐山063001 [2]华北理工大学附属医院超声科,河北唐山063001

出　　处：《转化医学杂志》2024年第11期1825-1829,共5页Translational Medicine Journal

基　　金：河北省2021年度医学科学研究课题(20210402)。

摘　　要：目的研究甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)/AFP联合超声造影在鉴别肝硬化和肝癌中的价值。方法回顾性选取开滦总医院2021年3月至2024年3月经病理检验证实的95例肝硬化患者和33例肝癌患者分别纳入对照组、观察组,对比2组临床资料、AFP、AFP-L3/AFP以及超声造影检查结果,分析AFP、AFP-L3/AFP联合超声造影在鉴别肝硬化和肝癌中的诊断效能。结果观察组AFP、AFP-L3/AFP、峰值强度(PI)、增强斜率(ES)高于对照组,但增强时间(ET)、达峰时间(TTP)较对照组更低(P<0.05)。构建列线图模型鉴别肝硬化和肝癌的校准曲线接近于理想曲线,且AFP、AFP-L3/AFP及超声造影参数联合鉴别肝硬化和肝癌的AUC为0.997(95%CI:0.992-1.000),明显高于单一指标,意味着联合鉴别的诊断效能更高(P<0.05)。结论AFP、AFP-L3/AFP联合超声造影在鉴别肝硬化和肝癌中具有重要意义,敏感度及特异度较高,值得临床推广使用。Objective To study the value of alpha-fetoprotein(AFP),alpha-fetoprotein heterodimer(AFP-L3)/AFP combined with ultrasonography in identifying cirrhosis and hepatocellular carcinoma.Methods Ninety-five patients with cirrhosis and 33 patients with hepatocellular carcinoma confirmed by pathological examination from March 2021 to March 2024 in Kailuan General Hospital were retrospectively selected to be included in the control group and the observation group,respectively,and the clinical data,AFP,AFP-L3/AFP,and ultrasonography results of the groups were compared,and the combined ultrasonography with AFP and AFP-L3/AFP was analyzed to determine the diagnostic efficacy.Results AFP,AFP-L3/AFP,peak intensity(PI),and enhancement slope(ES)were higher in the observation group than in the control group,but the enhancement time(ET)and time to peak(TTP)were lower than those in the control group(P<0.05).The calibration curve for constructing the column-line graph model to identify cirrhosis and hepatocellular carcinoma was close to the ideal curve,and the AUC of the combined identification of cirrhosis and hepatocellular carcinoma by AFP,AFP-L3/AFP and ultrasonography parameters was 0.997(95%CI:0.992-1.000),which was significantly higher than that of a single index,implying that the diagnostic efficacy of the combined differentiation was higher(P<0.05).Conclusion The combined ultrasonography of AFP and AFP-L3/AFP is of great significance in the differentiation of cirrhosis and hepatocellular carcinoma,with high sensitivity and specificity,and is worth promoting its use in clinical practice.

关 键 词：肝硬化 甲胎蛋白 肝癌 甲胎蛋白异质体 

分 类 号：R735.7[医药卫生—肿瘤]