摘要
目的探讨血清异常凝血酶原(DCP)和甲胎蛋白(AFP)联合诊断模型在原发性肝癌中的价值。方法收集2016年-2020年于驻马店中心医院就诊经病理诊断的原发性肝癌患者226例,作为研究组,收集同期肝脏良性病变和正常人群共199例,作为对照组。通过电化学发光检测AFP浓度、化学发光微粒子发检测DCP浓度。用中位数和四分位数描述各组间DCP和AFP水平;组间两两比较采用Mann-Whitney U检验;绘制ROC曲线,得到cut-off值;R语言建立联合诊断模型及列线图,绘制ROC曲线,计算ROC曲线下面积,最后计算其诊断效能。结果研究组和对照组有统计学意义((AFP:U=3501 P<0.001;DCP:U=4033 P<0.001).),AFP和DCP的cut-off值为:24.4(ng/ml)、49.33(mAU/ml),其AUC分别为:0.784和0.903;AFP、DCP和AFP+DCP联合诊断的敏感性为:0.540、0.757、0.805,特异性为:0.810、0.920、0.989,建议预测模型,表明AFP和DCP的值越高,发生PHC的风险越高。结论血清异常凝血酶原和甲胎蛋白联合诊断在原发性肝癌中的价值优于单独血清异常凝血酶原和甲胎蛋白。
Objective To investigate the value of protein induced by vitamin K antagonist-Ⅱ(DCP)and alpha fetoprotein(AFP)in the diagnosis of primary liver cancer.Methods 226 patients with primary liver cancer diagnosed by pathology in Zhumadian Central Hospital from 2016 to 2020 were collected as the study group,a total of 199 cases includingpatients undergoing benign liver lesions and normal people were collectedas control group.AFP concentration was detected by electrochemiluminescence and DCP concentration was detected by chemiluminescence.Median and quartile were used to describe DCP and AFP levels in each group.Mann Whitney U test was used for pairwise comparison betweentwo groups;ROC curve wasdrawnto get cut-off value.R language was used to establish the joint diagnosis model and line graph.The ROC curvewasdrawn,the area under the ROC curve wascalculated,and finally diagnosis efficiencywas calculated.Results There was significant difference between the study group and the control group(AFP:u=3501,P<0.001;DCP:u=4033,P<0.001).The cut-off values of AFP and DCP between the study group and the control groupwere 24.4(ng/ml)and 49.33(m AU/ml),and the AUC oftwo groupswere 0.784 and 0.903 respectively;The sensitivity of AFP,DCP and AFP+DCP combined diagnosis was0.540,0.757 and 0.805,and the specificity was 0.810,0.920 and 0.989.The prediction model showed that the higher values of AFP and DCP were,the higher risk PHC had.Conclusion The value of combined diagnosis of protein induced by vitamin K antagonist-Ⅱand alpha fetoprotein in primary liver cancer is better than that of protein induced by vitamin K antagonist-Ⅱand alpha fetoprotein alone.
作者
邢思远
邱卫强
XING Siyuan;QIUWeiqiang(Department of Clinical Laboratory,Zhumadian Central Hospital,Zhumadian,463000,Henan,China)
出处
《新疆医学》
2022年第12期1423-1426,共4页
Xinjiang Medical Journal
关键词
原发性肝癌
血清异常凝血酶原
甲胎蛋白
列线图
primary liver cancer
protein induced by vitamin K absence or antagonist-Ⅱ
hepatocellular carcinoma
alpha-fetoprotein
Nomogram
