三种血清标志物联合检测在早期肝细胞肝癌中的诊断价值

发布时间：2018-09-16 18:57

【摘要】：目的探讨血清高尔基体蛋白73(GP73)、α-L岩藻糖苷酶(AFU)和甲胎蛋白(AFP)联合检测对早期肝细胞癌(HCC)的诊断价值。方法收集2016年3月至2017年3月该院肝病患者222例,根据疾病类型分为早期HCC组(74例)、晚期HCC组(27例)、肝硬化组(74例)、慢性乙型肝炎组(47例),另选取同期体检健康者49例作为健康对照组。分别测定各组血清AFP、AFU和GP73水平,绘制受试者工作特征(ROC)曲线,评价3项指标单独和联合检测对早期HCC的诊断价值。结果早期HCC组GP73、AFU和AFP水平均明显高于肝硬化组、慢性乙型肝炎组和健康对照组(P0.05)。在肝癌筛查时,AFP单独诊断的ROC曲线下面积(AUC)为0.910(95%CI:0.864~0.936),两项指标联合时GP73和AFP联合诊断的AUC最大[0.925(95%CI:0.889~0.950)],灵敏度最高(95.0%)。在鉴别诊断早期HCC与肝硬化时,单独诊断以GP73的AUC最大[0.842(95%CI:0.746~0.879)],特异度最高(86.5%);两项指标联合时GP73和AFU联合诊断的AUC最大[0.901(95%CI:0.788~0.907)]。结论 GP73与AFP联合检测可以提高HCC筛查的诊断效能,GP73和AFU联合诊断能够提高早期HCC诊断效能,对于早期HCC和肝硬化的鉴别诊断具有重要意义。
[Abstract]:Objective to investigate the diagnostic value of serum Golgi body protein 73 (GP73), 伪 -L fucosidase (AFU) and alpha-fetoprotein (AFP) in the diagnosis of early hepatocellular carcinoma (HCC). Methods 222 patients with liver disease were collected from March 2016 to March 2017. According to the type of disease, they were divided into early HCC group (74 cases), late HCC group (27 cases), cirrhosis group (74 cases) and chronic hepatitis B group (47 cases). The serum levels of AFP,AFU and GP73 were measured, and the (ROC) curves of the subjects' operating characteristics were drawn to evaluate the diagnostic value of the three indexes in the early stage of HCC. Results the levels of GP73,AFU and AFP in early HCC group were significantly higher than those in cirrhosis group, chronic hepatitis B group and healthy control group (P0.05). The area under the ROC curve was 0.910 (95%CI:0.864~0.936) when the AFP was separately diagnosed at the time of liver cancer screening. The maximum AUC (95%CI:0.889~0.950) and the highest sensitivity (95.0%) were obtained in the combined diagnosis of GP73 and AFP when the two indexes were combined. In the differential diagnosis of early HCC and cirrhosis, the AUC of GP73 alone was the largest [0.842 (95%CI:0.746~0.879)], the specificity was the highest (86.5%), and the AUC of GP73 and AFU combined diagnosis was the largest [0.901 (95%CI:0.788~0.907)]. Conclusion the combined detection of GP73 and AFP can improve the diagnostic efficacy of HCC screening. The combined diagnosis of GP73 and AFU can improve the diagnostic efficacy of early HCC. It is of great significance for the differential diagnosis of early HCC and cirrhosis.
【作者单位】：重庆医科大学附属第一医院医学检验科;重庆医科大学附属第一医院输血科;
【基金】：国家自然科学基金资助项目(30670965)
【分类号】：R730.43;R735.7

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