摘要
目的:探讨血清异常凝血酶原(DCP)、甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、热休克蛋白90α(HSP90α)检测在原发性肝细胞癌(HCC)诊断中的临床应用价值,为临床提供参考.方法:选取2021年10月—2022年6月安徽医科大学附属巢湖医院收治的64例原发性肝癌(PHC)患者作为研究对象,将其中50例HCC患者与同期就诊的30例失代偿期肝硬化患者、30例乙型病毒性肝炎患者及30例健康人群分为HCC组、肝硬化组、肝炎组及健康对照组,检测并比较分析所有研究对象血清DCP、AFP、AFP-L3、HSP90α水平.结果:HCC组血清AFP、AFP-L3、DCP、HSP90α水平及GALAD评分均较其他三组高,差异有统计学意义(H=39.885、28.618、57.601、46.252、85.734,P＜0.05).绘制ROC曲线,AFP、AFP-L3、DCP、HSP90α及GALAD评分的受试者工作特征曲线下面积(AUC)分别为0.804、0.680、0.883、0.838及0.936.GALAD评分联合HSP90α诊断的AUC最高,为0.940.AFP、DCP与HSP90α三者联合可将诊断敏感度提高至84.0%.HBV组AFP、DCP水平及GALAD评分均高于非HBV组,差异有统计学意义(Z=-2.251、-1.668、-2.288,P＜0.05),两组AUC值最高者均为GALAD,分别为0.951、0.903.结论:HCC相关肿瘤标志物单项检测敏感性较低,联合检测可明显提高诊断敏感性和准确性,增加HCC筛查阳性率.
Abstract
Objective:To investigate the clinical application value of serum abnormal prothrombin(DCP),alpha-fetoprotein(AFP),alpha-fetoprotein isoplast(AFP-L3)and heat shock protein 90α(HSP90α)in the diagnosis of primary hepatocellular carcinoma(HCC).Methods:64 patients with primary hepatocelluar carcinoma admitted to Chaohu Affiliated Hospital of Anhui Medical Wiversity were selected.50 HCC patients,30 decompensated cirrhosis patients,30 viral hepatitis B patients and 30 healthy people were divided into HCCgroup,liver cirrhosis group,hepatits group and healthy group.Serum DCP,AFP,AFP-L3 and 90α levels were compared and analyzed.Results:Serum levels of AFP,AFP-L3,DCP,HSP90α and GALAD score in HCC group were higher than those in other three groups,and the difference was statistically significant(H=39.885,28.618,57.601,46.252,85.734;P＜0.05).The area under receiver operating characteristic curve(AUC)of AFP,AFP-L3,DCP,HSP90α and GALAD scores were 0.804,0.680,0.883,0.838 and 0.936,respectively.The AUC of GALAD score combined with HSP90α diagnosis was the highest(0.940),and the sensitivity was 84.0%.The levels of AFP,DCP and GALAD in HBV group were higher than those in non-HBV group,and the difference was statistically significant(Z=-2.251,-1.668,-2.288;P＜0.05).The highest values of AUC in both groups were GALAD(0.951 and 0.903).Conclusion:The sensitivity of single detection of HCC related tumor markers is low.Combined detection can significantly improve the diagnostic sensitivity and accuracy,and increase the positive rate of HCC screening.
NETL
NSTL
维普
万方数据