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肿瘤标志物联合D-二聚体诊断肝癌合并门静脉癌栓的临床意义

发布时间:2018-07-23 08:53
【摘要】:目的:探讨肿瘤标志物联合D-二聚体诊断HCC合并PVTT的临床意义。方法:本研究的对象是2015年1月至2016年12月在浙江大学医学院附属第一医院住院就诊,术前检查或者术后病理诊断为HCC无或合并PVTT的71名患者,对其临床资料进行了回顾性分析。使用SPSS软件进行统计分析。用卡方检验对各组数据进行比较,使用ROC曲线来分析敏感度、特异度、确定诊断PVTT的cut-off值。P0.05可认为有统计学意义。结果:本研究收集了诊断HCC是否合并PVTT可能具有临床意义的4个因素,分别如下所述。AFP的ROC曲线面积图为0.827,将AFP分为阳性组(≥725.85 μg/L)组和阴性组(725.85μg/L)组,敏感度为0.773,特异度为0.893,两组数据有显著性差异(P=0.000);D-二聚体的ROC面积图为0.833,将D-二聚体分为阳性组(≥535.50μg/L)和阴性组(535.50μg/L),敏感度为0.933,特异度为0.750,两组数据有显著性差异(P=0.000);CA125的ROC曲线面积图为0.769,将CA125分为阳性组(20.90 U/mL)和阴性组(20.90 U/mL),敏感度为0.667,特异度为0.821,两组数据有显著性差异(P=0.001);CA19-9的ROC面积图为0.713,将CA19-9阳性组(≥8.25 U/mL)和阴性组(8.25 U/mL),敏感度为0.800,特异度为0.589,两组数据有显著性差异(P=0.012)。AFP联合D-二聚体的串联试验(AFP≥725.85 μg/L且D-二聚体≥535.50μg/L为阳性,其余为阴性):得出敏感度为0.733,特异度为0.982,卡方检验提示两组数据有显著性差异(P=0.000),并联试验(AFP≥725.85μg/L或D-二聚体≥535.50μg/L为阳性,其余为阴性):得出敏感度为0.933,特异度为0.661,卡方检验提示两组数据有显著性差异(P=0.000);AFP联合CA125的串联试验(AFP≥725.85μg/L且CA125≥20.90U/mL为阳性,其余为阴性):得出敏感度为0.600,特异度为0.982,卡方检验提示两组数据有显著性差异(P=0.000),并联试验(AFP≥725.85μg/L或CA125≥20.90U/mL为阳性,其余为阴性):得出敏感度为0.800,特异度为0.732,卡方检验提示两组数据有显著性差异(P=0.001);CA125联合D-二聚体的串联试验(CA125≥20.90 U/mL且D-二聚体≥535.50μg/L为阳性,其余为阴性):得出敏感度为0.667,特异度为0.875,卡方检验提示两组数据有显著性差异(P=0.000),并联试验(CA125≥20.90 U/mL或D-二聚体≥535.50 μg/L为阳性,其余为阴性):得出敏感度为0.933,特异度为0.696,卡方检验提示两组数据有显著性差异(P=0.000)。结论:1.AFP、CA125、CA19-9、D-二聚体对独立诊断是否合并PVTT的HCC患者具有临床意义,其中AFP、CA125、D-二聚体具有较高诊断价值。2.肿瘤标志物联合D-二聚体对联合诊断是否合并PVTT的HCC患者具有临床意义,联合检测肿瘤标志物及D-二聚体可提高PVTT的早期发现率。
[Abstract]:Objective: to investigate the clinical significance of tumor markers combined with D-dimer in diagnosis of HCC with PVTT. Methods: from January 2015 to December 2016, 71 patients with HCC without or with PVTT were admitted to the first affiliated Hospital of Zhejiang University Medical College. The clinical data were analyzed retrospectively. SPSS software was used for statistical analysis. The data of each group were compared by chi-square test, the sensitivity and specificity were analyzed by ROC curve, and the cut-off value of diagnosis was determined. P05 could be regarded as statistically significant. Results: in this study, we collected four factors that might be of clinical significance in the diagnosis of HCC with PVTT. The ROC curve area map of AFP was 0.827. AFP was divided into positive group (鈮,

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