Objective To evaluate the efficacy of individual and combined use of alpha fetoprotein (AFP), abnormal prothrombin Ⅱ(PIVKA Ⅱ),and ferritin indicators in the diagnosis and prognosis evaluation of liver cancer.Methods A retrospective analysis was conducted on the AFP,PIVKA-Ⅱ,and ferritin detection values from physical examination,outpatient,and inpatient settings in the field of nuclear medicine within 10 months period.According to clinical diagnostic information,patients were divided into the health examination group, hepatitis liver cyst group, cirrhosis group, adenomatous hyperplasia group, and malignant liver cancer group.The expression levels of each indicator in each liver related group were compared.We then evaluated the application characteristics of AFP and PIVKA-Ⅱ through Passing Bablock regression analysis and Kappa analysis.We compared and analyzed the efficacy of various indicators and combined application models in the diagnosis of liver malignant tumors through ROC curves and Kappa.We also compared the evaluation value of various indicators in the prognosis of liver malignant tumors.Results The expression differences of the three indicators in each group were significant.The positive detection rate of AFP in the healthy population was 4.05％,while the positive detection rate in the liver cancer group was 57.61％;The positive detection rate of PIVKA-Ⅱ in the health examination group was 4.05％,while in the liver cancer group it was 64.47％;The positive detection rate of ferritin in the health examination group was 12.16％,while in the liver cancer group it was 34.90％.The correlation between AFP and PIVKA-Ⅱ indicators was:Y=0.0786X+1.5675,with significant linear deviation;Consistency analysis showed a Kappa value of 0.381,indicating moderate consistency.The diagnostic efficiency of the combination of multiple indicators in the liver cancer group was higher than that of a single indicator,with an area under the ROC curve of 0.802.The area under the ROC curve diagnosed in the adenoma hyperplasia+liver cancer group was 0.771;In the diagnosis of liver cancer,the sensitivity of AFP,ferritin,and PIVKA-Ⅱ combined tests was 88.96％,with a specificity of 80.24％,which was higher than the sensitivity of single-item detection.In the diagnosis of benign and malignant tumors,the sensitivity of the three combined tests was 82.52％,with a specificity of 78.53％.The three indicators showed significant differences before and after liver cancer treatment.The median of AFP decreased from 4.11ng/mL to 3.2ng/mL,while ferritin decreased from 244 ng/mL to 223ng/mL,and PIVKA-Ⅱ decreased from 161mIU/mL to 24.78mIU/mL before and after treatment;Rank sum test analysis of numerical differences before and after treatment showed:AFP:P<0.0247;ferritin:P<0.4842;PIVKA-Ⅱ:P<0.0001,and changes in AFP and PIVKA-Ⅱ indicators had stronger clinical consistency and prognostic guidance value. Conclusion There are significant differences in the expression of three traditional liver cancer detection indicators in benign and malignant diseases.Among them,the two core indicators AFP and PIVKA-Ⅱ have a poor consistency,but strong complementarity.Joint testing can effectively improve the positive detection rate.The diagnostic efficacy of multiple indicators combined with adenomatous hyperplasia and malignant liver cancer is higher for simple malignant liver cancer.The efficacy monitoring value of AFP and PIVKA-Ⅱ is even higher.
维普
万方数据