摘要
目的 探讨血清甲胎蛋白（AFP）、α-L-岩藻糖苷酶（AFU）、5＇-核苷酸酶（5＇-NT）和γ-谷氨酰转肽酶（GGT）检测在肝细胞癌（HCC）诊断中的应用,为HCC早期、快速诊断提供依据.方法 回顾性分析2013年6月至2014年10月首诊为HCC的患者120例（HCC组）、肝硬化患者150例（肝硬化组）、肝炎患者200例（肝炎组）,同时选择同期健康体检者100例作为健康对照组.分别采用电化学发光法、速率法、过氧化物酶法和酶比色法测定血清AFP、AFU、5＇-NT和GGT水平,绘制受试者工作特征（ROC）曲线,计算灵敏度、特异度及曲线下面积（AUC）.结果 HCC组、肝硬化组、肝炎组和健康对照组血清AFP、AFU、5＇-NT和GGT的水平两两比较差异均有统计学意义（均P＜0.05）.AFP、AFU、5＇-NT和GGT单独检测HCC的灵敏度分别为58.33 ％（70/120）、82.50 ％（99/120）、85.00％（102/120）、78.33 ％（94/120）,特异度分别为88.33％（106/120）、73.33 ％（88/120）、88.33％（106/120）、71.67 ％（86/120）,AUC分别为0.655、0.702、0.814、0.754,四项指标联合检测HCC的灵敏度为98.33 ％（118/120）,特异度为96.67 ％（116/120）,AUC为0.975,均较单项检测高（均P＜0.05）.结论 血清AFP、AFU、5＇-NT和GGT联合检测可提高HCC诊断的灵敏度和特异度,能够优势互补,对HCC的早期和快速诊断具有重要的临床意义.
Objective To investigate the application of alpha-fetoprotein （AFP）,α-L-fucosidase（AFU）,5＇-nucleotidase（5＇-NT） and γ-glutamyltransferase （GGT） in diagnosis of hepatocellular carcinoma（HCC）,and to provide the basis for its early and rapid diagnosis.Methods The clinical data of 120 cases with initial diagnosis as hepatocellular carcinoma,150 cases with liver cirrhosis,200 cases with hepatitis were analyzed retrospectively from June 2013 to August 2014,meanwhile,100 healthy people were selected as control group.The serum AFP,AFU,5＇-NT and GGT levels were measured by electrochemiluminescence immunoassay,rate method,peroxidase method and enzymatic colorimetric assay,respectively.The results were analyzed by receiver operating characteristic （ROC） curve,while the sensitivity,specificity,AUC were calculated at the same time.Results The levels of serum AFP,AFU,5＇-NT and GGT were significantly different among HCC group,liver cirrhosis group,hepatitis group and control group （all P〈0.05）.When tested alone,the sensitivities of AFP,AFU,5＇-NT and GGT were 58.33 %（70/120）,82.50 %（99/120）,85.00 %（102/120）,78.33 %（94/120）,the specificities were 88.33 %（106/120）,73.33 %（88/120）,88.33 %（106/120）,71.67 %（86/120）,and AUC were 0.655,0.702,0.814,0.754.When four indexes were performed with combined test,the sensitivity was 98.33 %（118/120）,specificity was 96.67 %（116/120）,AUC was 0.975,which were higher than the single detection （all P〈0.05）.Conclusion The combined detection of serum AFP,AFU,5＇-NT and GGT can greatly increase the sensitivity and specificity for diagnosing HCC and will gain mutual complement advantages,which is of great clinical value for early and rapid diagnosis.
出处
《肿瘤研究与临床》
CAS
2016年第8期519-522,527,共5页
Cancer Research and Clinic
基金
宝鸡市卫生和计划生育委员会（原卫生局）课题（201309）
