摘要
目的:探究有创性与无创性检测在肝纤维化分期中的应用效果。方法:选取2018年1-3月于本院进行治疗的86例确诊为肝纤维化患者为研究对象,按照其病理检查结果将其分为S1组(n=19)、S2组(n=22)、S3组(n=20)、S4组(n=25)。分别检测四组血清学指标(HA、Ⅳ-C、LN)、超声检测指标(肝硬度值、超声评分)、肿瘤标志物(AFP、CA125、CA19-9)水平,比较3种无创检测与有创性检测在肝纤维化分期中诊断一致性。结果:S4组HA、Ⅳ-C及LN水平均高于其他三组,S3组均高于S2、S1组,且S2组均高于S1组,组间比较差异均有统计学意义(P<0.05);S4组肝硬度及超声评分均高于其他三组,S3组均高于S2、S1组,且S2组均高于S1组,组间比较差异均有统计学意义(P<0.05);S4组AFP、CA125、CA19-9水平均高于其他三组,S3组均高于S2、S1组,且S2组均高于S1组,组间比较差异均有统计学意义(P<0.05);经一致性检验,发现血清学指标、超声检测、肿瘤标志物与肝穿活检病理检测结果均有较高的一致性(Kappa=0.635、0.623、0.329,P<0.05)。结论:无创性检测如血清学指标、超声检测及肿瘤标志物对肝纤维化分期均有较高的诊断价值,与有创性检测病理结果有较高的一致性,值得进行临床推广使用。
Objective：To explore the application effect of invasive and non-invasive detection in staging of liver fibrosis.Method： A total of 86 patients with liver fibrosis who were treated in our hospital from January to March 2018 were selected as the subjects.According to the results of pathological examination,they were divided into S1 group（n=19）,S2 group（n=22）,S3 group（n=20）,S4 group（n=25）.The serological indicator（HA,Ⅳ-C,LN）,ultrasonic indexes（liver stiffness,ultrasonic score） and tumor markers（AFP,CA125,CA19-9） were measured in four groups,the consistency of three non-invasive detection and invasive detection in staging of liver fibrosis were compared.Result： The levels of HA,Ⅳ-C and LN in S4 group were higher than those of the other three groups,S3 group were higher than those of S2 and S1 groups,and S2 group were higher than those of S1 group,the differences were statistically significant（P〈0.05）.The liver stiffness,ultrasonic score in S4 group were higher than those of the other three groups,S3 group were higher than those of S2 and S1 groups,and S2 group were higher than those of S1 group,the differences were statistically significant（P〈0.05）.The levels of AFP,CA125,CA19-9 in S4 group were higher than those of the other three groups,S3 group were higher than those of S2 and S1 groups,and S2 group were higher than those of S1 group,the differences were statistically significant（P〈0.05）.The consistency test showed that the serological indicator,ultrasonic testing,tumor marker were in good agreement with the results of liver biopsy（Kappa=0.635,0.623,0.329,P〈0.05）. Conclusion：Non-invasive detection such as serological indicator,ultrasound detection and tumor markers have high diagnostic value for liver fibrosis staging,and have high consistency with pathological results of invasive detection,which is worthy of clinical application.
作者
熊慧
毛龙细
熊小蔚
孙明生
黄神安
XIONG Hui;MAO Longxi;XIONG Xiaowei(The Third Affiliated Hospital of Nanchang University,Nanchang 330008,China)
出处
《中国医学创新》
CAS
2018年第31期5-8,共4页
Medical Innovation of China
基金
江西省卫生计生委科技计划项目(20171878)
关键词
有创检测
无创检测
肝纤维化
分期
Invasive detection
Non-invasive detection
Liver fibrosis
Staging
