摘要
目的探讨甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)和异常凝血酶原(PIVKA-Ⅱ)单独及联合检测在肝细胞癌(HCC)诊断中的应用价值。方法分析2020年6月-2020年10月在中山大学附属第三医院首次确诊的120例肝细胞癌患者、77例乙肝肝硬化患者和105例慢性乙型肝炎患者血清学指标,分析AFP不同水平人群中AFP、AFP-L3、PIVKA-Ⅱ单独及联合检测肝细胞癌的诊断效能。结果肝细胞癌组血清AFP、AFP-L3和PIVKA-Ⅱ水平高于乙肝肝硬化组和慢性乙型肝炎组,差异有统计学意义(P<0.001)。受试者工作特征曲线(ROC)分析显示:在总人群中,AFP、AFP-L3和PIVKA-Ⅱ三者联合与PIVKA-Ⅱ单独检测在肝细胞癌的诊断效能高于AFP和AFP-L3单独检测诊断效能(AUC=0.867、0.869、0.690、0.701);在AFP阴性人群(AFP≤20 ng/mL)中,AFP、AFP-L3和PIVKA-Ⅱ三者联合在肝细胞癌的诊断效能低于PIVKA-Ⅱ单独检测诊断效能,但高于AFP和AFP-L3单独检测诊断效能(AUC=0.759、0.841、0.502、0.491)。结论血清PIVKA-Ⅱ指标对AFP阴性肝癌具有重要诊断价值,可与AFP互为补充提高肝细胞癌的早期诊断率。
Objective To explore the individual and combined value of alpha-fetoprotein(AFP),alpha-fetoprotein-L3(AFPL3)and prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ)in the diagnosis of hepatocellular carcinoma(HCC).MethodsThe related serological indexes of 120 patients with hepatocellular carcinoma,77 patients with liver cirrhosis and 105 patients with chronic hepatitis B were collected in the Third Affiliated Hospital of Sun Yat-sen University between June 2020 and October 2020 and retrospectively analyzed.The diagnostic accuracy of the individual and combined values of AFP,AFP-L3 and PIVKA-Ⅱin the diagnosis of HCC among patients with different levels of AFP were evaluated.Results The serum AFP,AFP-L3,PIVKA-Ⅱlevels in patients with HCC were higher than those in patients with liver cirrhosis and chronic hepatitis B.ROC statistics showed that in the total population,the performances of the combined index of AFP,AFPL3,PIVKA-Ⅱand the individual index PIVKA-Ⅱalone in diagnosing HCC were higher than those of the individual index AFP and AFP-L3 alone(AUC=0.867,0.869,0.690,0.701).While in AFP-negative population(AFP≤20 ng/mL),the performance of the combined index of AFP,AFP-L3,PIVKA-Ⅱin diagnosing HCC was lower than the individual index PIVKA-Ⅱalone,but higher than those of the individual index AFP and AFP-L3 alone(AUC=0.759,0.841,0.502,0.491).ConclusionsPIVKA-Ⅱhad great diagnostic value for AFP-negative HCC.PIVKA-Ⅱand AFP could be complementary and improve the early diagnosis rate of HCC.
作者
陈家豪
叶彩玲
孙恒昌
李朝霞
CHEN Jia-hao;YE Cai-ling;SUN Heng-chang;LI Zhao-xia(Department of Laboratory Medicine,Third Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510000,China)
出处
《热带医学杂志》
CAS
2022年第5期677-680,共4页
Journal of Tropical Medicine
基金
广州市科技计划项目(201903010034)
中山大学附属第三医院国家自然科学基金培育专项资助项目(2020GZRPYQN23)
关键词
肝细胞癌
甲胎蛋白
甲胎蛋白异质体
异常凝血酶原
Hepatocellular carcinoma
Alpha-fetoprotein
Alpha-fetoprotein-L3
Prothrombin induced by vitamin K absence-Ⅱ
