摘要
目的探讨维生素K缺乏拮抗剂Ⅱ诱导蛋白(PIVKA-Ⅱ)、甲胎蛋白(AFP)、甲胎蛋白异质体L3(AFP-L3)联合检测在肝细胞癌(HCC)中的临床诊断价值。方法收集自2017-11～2018-08在蚌埠医学院第一附属医院就诊的肝细胞癌患者作为研究组,肝硬化、肝炎和健康体检者作为对照组,共130例,其中肝细胞癌组(HCC) 40例,肝硬化组(LC) 30例、肝炎组(CHB) 30例、健康组(HG) 30例。化学发光法检测其血浆PIVKA-Ⅱ、AFP、AFP-L3含量,并绘制受试者工作特征曲线(ROC)判断其在HCC中的诊断价值。结果与肝硬化组、肝炎组、健康组分别比较,HCC组血浆PIVKA-Ⅱ、AFP和AFP-L3差异均有统计学意义(P <0. 05)。PIVKA-Ⅱ、AFP、AFP-L3单独诊断HCC时的AUC分别为0. 871(95%CI 0. 801-0. 923),0. 844(95%CI 0. 770-0. 901),0. 836(95%CI 0. 761-0. 895),PIVKA-Ⅱ的AUC最大,诊断性能最佳,差异具有统计学意义(P <0. 05)。联合检测时PIVKA-Ⅱ+AFP的AUC最大为0. 931(95%CI 0. 829-0. 968),优于单独检测。结论 PIVKA-Ⅱ、AFP、AFP-L3对HCC具有重要的诊断价值,联合检测优于单独检测,确定最佳参考值有助于提高诊断HCC的特异度。
Objective To investigate the clinical diagnostic value of combined detection of protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ), alpha-fetoprotein(AFP) and Lens culinaris agglutinin-reactive fraction of AFP(AFP-L3) in hepatocellular carcinoma(HCC). Methods A total of 130 subjects with hepatocellular carcinoma, cirrhosis, hepatitis and healthy examination subjects were collected from the First Affiliated Hospital of Bengbu Medical College from November 2017 to August 2018. There were 40 patients in hepatocellular carcinoma(HCC) group, 30 in cirrhosis group, 30 in hepatitis group, and 30 in healthy group(HG). The plasma levels of PIVKA-Ⅱ, AFP, and AFP-L3 were measured by chemiluminescence, and receiver operating characteristic curves(ROC) were plotted to determine their diagnostic value in HCC. Results The plasma PIVKA-Ⅱ, AFP and AFP-L3 levels were significantly higher in HCC group than those in cirrhosis group, hepatitis group and healthy group( P <0.05). The AUCs of PIVKA-Ⅱ,AFP, and AFP-L3 alone in the diagnosis of HCC were 0.871(95% CI 0.801-0.923), 0.844(95% CI 0.770-0.901), and 0.836(95% CI 0.761-0.895), respectively, and PIVKA-Ⅱ had the largest AUC and the best diagnostic performance, with a statistically significant difference( P <0.05). The maximum AUC of PIVKA-Ⅱ+AFP was 0.931(95% CI 0.829-0.968), which was better than that of single detection. Conclusion PIVKA-Ⅱ, AFP and AFP-L3 have important values in the diagnosis of HCC, and the diagnostic performance of combined detection is superior to that of single detection. Determining the best reference value is helpful to improve the specificity of diagnosis of HCC.
作者
胡迪
马梦亭
李明远
王凤超
张伦军
孙红
HU Di;MA Mengting;LI Mingyuan;WANG Fengchao;ZHANG Lunjun;SUN Hong(Department of Clinical Laboratory, First Affiliated Hospitalof Bengbu Medical College,Bengbu 233000,China)
出处
《山西医科大学学报》
CAS
2019年第4期405-409,共5页
Journal of Shanxi Medical University
关键词
肝细胞癌
异常凝血酶原
甲胎蛋白
甲胎蛋白异质体
hepatocellular carcinoma
protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)
alpha-fetoprotein
Lens culinaris agglutinin-reactive fraction of AFP(AFP-L3)
