摘要
目的探讨血清中肿瘤标志物AFP、AFP-L3及异常凝血酶原(PIVKA-Ⅱ)单独以及联合检测在原发性肝癌诊断中的临床价值。方法回顾性分析从我院收集到的肝病患者共243例,其中PHC组98例,病毒性肝炎组63例,肝硬化组82例,另外从我院体检科选取80例体检健康者作为正常对照组,对以上所有研究对象进行血清AFP、AFP-L3及PIVKA-Ⅱ的检测和分析。结果PHC组血清中AFP、AFP-L3及PIVKA-Ⅱ中位水平均明显高于正常对照组、病毒性肝炎组及肝硬化组(P均<0.05)。AFP、AFP-L3及PIVKA-Ⅱ诊断PHC时ROC曲线下面积(AUC)分别为0.843、0.610及0.901。血清中这三种肿瘤标志物诊断PHC时单独检测的灵敏度分别为69.4%、61.2%、80.6%,特异性分别为77.2%、89.0%、82.7%,联合检测串联时特异性提高到95.1%,并联时灵敏度提高到91.8%。结论血清AFP、AFP-L3和PIVKA-Ⅱ在临床上对于PHC的诊断有着非常高的临床价值,三项指标联合检测对于PHC的诊断效能有明显提高。
Objective To investigate the clinical diagnostic value of single or combined detection of serum tumor markers Alpha-fetoprotein(AFP),Alpha-fetoprotein heterogeneity(AFP-L3),and abnormal prothrombin(PIVKA-II)for primary hepatic carcinoma(PHC).Methods 243 patients with liver diseases were collected for the study,including 98 PHC patients,63 viral hepatitis patients and 82 cirrhosis patients.In addition,80 cases of physical examination healthy patient data were selected as the normal control group.We detected and analyzed of all subject's serum levels of AFP,AFP-L3 and PIVKA-Ⅱ.Results The median levels of serum AFP,AFP-L3 and PIVKA-Ⅱ in PHC group were significantly higher than those in viral hepatitis group and cirrhosis group( P <0.05).The single detection AUCs of AFP,AFP-L3 and PIVKA-Ⅱ in the diagnosis of PHC were 0.843,0.610 and 0.901,respectively.The sensitivities of AFP,AFP-L3 and PIVKA-Ⅱ were 69.4%,61.2%and 80.6%,respectively.The specificities of AFP,AFP-L3 and PIVKA-Ⅱ were 77.2%,89.0%and 82.7%respectively.The specificity increased to 95.1%in sequencial combined-detection,and 91.8%in parallel combined-detection.Conclusion Serum AFP,AFP-L3 and PIVKA-Ⅱ have very high clinical values in the diagnosis of PHC,the combined detection of these three indicators can improve the diagnostic efficiency of PHC.
作者
吕春燕
裴豪
戴亚萍
王旭
LYU Chun-yan;PEI Hao;DAI Ya-ping;WANG Xu(Department of Clinical Laboratory,Wuxi Fifth people′s Hospital,Wuxi 214000,China)
出处
《标记免疫分析与临床》
CAS
2019年第7期1159-1162,共4页
Labeled Immunoassays and Clinical Medicine
