摘要
目的探讨异常凝血酶原-Ⅱ(abnormal prothrombin-Ⅱ,PIVKA-Ⅱ)与甲胎蛋白(alpha-fetoprotein,AFP)在原发性肝癌(hepatocellular carcinoma,HCC)诊断中的价值。方法选取我院2017年10月-2018年10月收治的肝病患者,包括原发性肝癌患者82例,其中男50例,女32例,平均年龄(63.20±8.32)岁;肝硬化患者、慢性肝炎患者各50例,男58例,女42例,平均年龄(61.41±6.92)岁;同期健康体检者50例,男31例,女19例,平均年龄(60.74±3.70)岁。利用ARCHTECT技术分别定量检测各组中PIVKA-Ⅱ与AFP的数值,分析PIVKA-Ⅱ与AFP的ROC曲线下面积(AUC)。结果 ROC曲线下分析显示单项检测中PIVKA-Ⅱ、AFP的AUC分别为0.954(95%CI:0.929～0.980)、0.842(95%CI:0.783～0.900);血清PIVKA-Ⅱ的最佳临界值为25.23 mAU/ml,AFP的最佳临界值为28.75 ng/ml;血清PIVKA-Ⅱ检测HCC的敏感度、特异度分别为80.49%、93.00%,血清AFP检测HCC的敏感度、特异度分别为65.85%、89.00%,单项检测血清PIVKA-Ⅱ的敏感度明显高于AFP(P <0.05);当两项指标并联检测时敏感度可高达85.37%,串联时特异度可高达96.0%。经过Spearman秩相关分析,PIVKA-Ⅱ、AFP的表达水平与原发性肝癌的肿瘤数量(r=0.347、0.218,P均<0.05)、TNM临床分期(r=0.494、0.355,P均<0.01)呈正相关。结论血清PIVKA-Ⅱ在HCC中的临床诊断价值优于AFP,两指标联合检测可提高HCC检测的敏感度。
Objective To investigate the diagnostic value of prothrombin-Ⅱ(PIVKA-Ⅱ)and alpha-fetoprotein(AFP)in primary hepatocellular carcinoma(HCC).Methods Patients with liver disease treated in our hospital were selected from October 2017 to October 2018,including 82 cases of primary liver cancer patients(50 males and 32 females with average age of 63.2±8.323 years),50 patients with chronic hepatitis and 50 patients with cirrhosis(58 males and 42 females with average age of 61.41±6.92 years),50 cases of healthy check-up during the same period(31 males and 19 females with average age of 60.74±3.697 years),the values of PIVKA-Ⅱand AFP in each group were detected by ARCHTECT technique,and the area under ROC curve(AUC)of PIVKA-Ⅱand AFP were calculated.Results The ROC curve analysis showed that the AUC of PIVKA-Ⅱand AFP to diagnose HCC were0.954(95%CI,0.929-0.980)and 0.842(95%CI,0.783-0.900),respectively;The cut-off value of serum PIVKA-Ⅱwas 25.23 mAU/ml and AFP was 28.75 ng/mL;The sensitivity and specicity were 80.49%and 93.00%,respectively for serum PIVKA-Ⅱin detecting HCC;and 65.85%and 89.00%,respectively for serum AFP;The sensitivity of serum PIVKA-Ⅱwas signicantly higher than that of AFP(P<0.05).When the two indexes were used in parallel,the sensitivity was 85.37%and the specicity in series was 96.0%;Spearman rank correlation analysis showed that the expression levels of PIVKA-Ⅱand AFP were positively related to the number of tumors(r=0.347,0.218,P<0.05,respectively)and TNM staging(r=0.494,0.355,P<0.01,respectively).Conclusion The clinical diagnostic value of serum PIVKA-Ⅱin HCC is better than that of AFP.
作者
王敏
张娜娜
李芮
王学哲
WANG Min;ZHANG Na’na;LI Rui;WANG Xuezhe(Department of Laboratory,First Affiliated Hospital of Jinzhou Medical College,Jinzhou 121001,Liaoning Province,China)
出处
《解放军医学院学报》
CAS
2019年第3期247-251,共5页
Academic Journal of Chinese PLA Medical School
关键词
原发性肝癌
异常凝血酶原-Ⅱ
甲胎蛋白
primary hepatic carcinoma
abnormal prothrombin-Ⅱ
alpha-fetoprotein
