摘要
目的探讨乙型肝炎肝硬化与肝癌患者乙型肝炎病毒DNA(HBV DNA)、血清甲胎蛋白异质体L3(AFP-L3)、高尔基蛋白73(GP73)的差异及HBV DNA与AFP-L3、GP73相关性。方法回顾该院2015年10月至2017年10月收治的乙型肝炎肝硬化患者和肝癌患者的临床资料,其中80例乙型肝炎肝硬化患者设为对照组,68例肝癌患者设为观察组。所有患者均采用PCR法检测血清HBV DNA,采用酶联免疫吸附法检测血清AFP-L3、GP73水平。比较两组患者血清HBV DNA、AFP-L3、GP73表达水平及阳性率的差异,采用Pearson相关对HBV DNA、AFP-L3、GP73相关性进行分析,并采用ROC曲线分析HBV DNA与AFP-L3、GP73在肝癌诊断中的价值。结果观察组患者HBV DNA、GP73表达阳性率高于对照组,但差异无统计学意义(P>0.05);观察组患者AFP-L3表达阳性率明显高于对照组,差异有统计学意义(χ2=55.01,P<0.001)。观察组患者血清HBV DNA、AFP-L3、GP73水平明显高于对照组,差异均有统计学意义(P<0.05)。分别将患者HBV DNA水平与AFP-L3、GP73水平作Pearson相关性分析,结果显示,HBV DNA与AFP-L3无相关性(r=0.214,P=0.079);HBV DNA与GP73表达无相关性(r=0.155,P=0.208)。采用ROC曲线对两组患者3种指标的鉴别诊断价值进行分析,3种指标均有一定的临床诊断价值(AUC>0.5),且AFP-L3在鉴别诊断中的应用价值最高(AUC=0.971,95%CI:0.943~0.999)。结论乙型肝炎肝硬化与肝癌患者HBV DNA、AFP-L3、GP73的水平存在明显差异,且肝癌患者血清HBV DNA与AFP-L3、GP73水平无明显相关性,AFP-L3在乙型肝炎肝硬化与肝癌的鉴别诊断中价值最高,值得在临床推广应用。
Objective To explore the differences of hepatitis B DNA(HBV DNA),serum alpha fetoprotein heterogeneity L3(AFP-L3),and Golgi protein 73(GP73)in hepatitis B cirrhosis and liver cancer patients,and as well as the correlation between HBV DNA and AFP-L3 and GP73.Methods The clinical data of hepatitis B patients with liver cirrhosis and patients with liver cancer treated in our hospital from October 2015 to October 2017 were reviewed.A total of 80 cases of patients with hepatitis B cirrhosis were selected as control group,and 68 cases of liver cancer patients were selected as observation group.Serum HBV DNA was detected by PCR in all patients.Serum AFP-L3 and GP73 levels were detected by enzyme-linked immunosorbent assay(ELISA).The differences of serum HBV DNA,AFP-L3 and GP73 expression levels and positive rates were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between HBV DNA,AFP-L3 and GP73,and ROC curves were used to analyze HBV DNA,AFP-L3 and GP73 in diagnosis of liver cancer.Results The positive rates of HBV DNA and GP73 in the observation group were higher than those in the control group,but there was no significant difference between the two groups(P>0.05).The positive rate of AFP-L3 expression in the observation group was significantly higher than that in the control group(χ2=55.01,P<0.001).The serum levels of HBV DNA and AFP-L3 and GP73 in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).The Pearson correlation analysis showed that there was no significant correlation between HBV DNA and AFP-L3(r=0.214,P=0.079).There was no significant correlation between HBV DNA and GP73 expression(r=0.155,P=0.208).The ROC curve showed that the three groups of indicators had clinical diagnostic value(AUC>0.5),and the AFP-L3 had the highest application value in differential diagnosis(AUC=0.971,95%CI:0.943-0.999).Conclusion The levels of HBV DNA,AFP-L3 and GP73 are different between hepatitis B liver cirrhosis and liver cancer patients,and there is no significant correlation between serum HBV DNA,AFP-L3 and GP73 in liver cancer patients.AFP-L3 has the highest value in the differential diagnosis of hepatitis B liver cirrhosis and liver cancer,which is worth of promotion.
作者
高莹
GAO Ying(Department of Clinical Laboratory,Wuhan Hospital of Traditional Chinese Medicine,Wuhan,Hubei 430000,China)
出处
《检验医学与临床》
CAS
2020年第7期938-941,共4页
Laboratory Medicine and Clinic
