摘要
目的探讨血清甲胎蛋白(AFP)、异常凝血酶原(PIVKA-Ⅱ)联合检测对原发性肝癌的诊断价值,为患者的临床诊治提供指导。方法选择2019年5~11月在南方医科大学深圳医院就诊的56例原发性肝癌患者作为观察组,选择我院同期体检健康人群50例作为对照组。检测并比较两组受检者的血清AFP、PIVKA-Ⅱ水平,采用受试者工作特征(ROC)曲线分析AFP、PIVKA-Ⅱ对原发性肝癌诊断的敏感度、特异度及准确度。结果观察组患者的血清AFP、PIVKA-Ⅱ水平分别为(132.63±17.24) ng/mL、(1 562.56±129.32) mAU/mL,明显高于对照组的(2.35±0.78) ng/mL、(20.08±2.13) mAU/mL,差异均有显著统计学意义(P<0.01);AFP诊断原发性肝癌的ROC曲线下面积为0.805,95%CI为0.723~0.888,PIVKA-Ⅱ诊断原发性肝癌的ROC曲线下面积为0.678,95%CI为0.577~0.779,AFP+PIVKA-Ⅱ诊断原发性肝癌的ROC曲线下面积为0.914,95%CI为0.890~0.939,AFP、PIVKA-Ⅱ单独检测分别和联合检测曲线下面积比较差异均有统计学意义(P<0.05);AFP+PIVKA-Ⅱ联合检测的敏感度、特异度及准确度为96.43%、92.86%及94.64%,均明显高于AFP的82.14%、76.79%、79.62%和PIVKA-Ⅱ的82.14%、75.00%、77.68%,差异均有统计学意义(P<0.05)。结论 AFP、PIVKA-Ⅱ对原发性肝癌均具有较高的诊断阳性率,且两者联合检测可提高原发性肝癌的诊断价值。
Objective To study the diagnostic value of combined detection of AFP and PIVKA-Ⅱ for primary liver cancer, to provide guidance for the clinical diagnosis and treatment of patients. Methods Fifty-six patients with primary liver cancer treated in Shenzhen Hospital of Southern Medical University from May 2019 to November 2019 were selected as the observation group, and 50 healthy people in our hospital were selected as the control group. The serum AFP and PIVKA-Ⅱ levels of the two groups were detected and compared. The sensitivity, specificity, and accuracy of AFP and PIVKA-Ⅱ in the diagnosis of primary liver cancer were analyzed by ROC curve. Results The levels of serum AFP and PIVKA-Ⅱ in the observation group were(132.63±17.24) ng/mL,(1 562.56±129.32) mAU/mL, significantly higher than(2.35±0.78) ng/mL,(20.08±2.13) mAU/mL in the control group(P<0.01). The area under ROC curve in the diagnosis of primary liver cancer was 0.805(95% CI 0.723-0.888) for AFP and 0.678(95% CI 0.577-0.779) for PIVKA-Ⅱ, which was significantly lower than 0.914(95% CI 0.890-0.939) for AFP+PIVKA-Ⅱ(P<0.05). The sensitivity, specificity, and accuracy of AFP+PIVKA-Ⅱ were 96.43%, 92.86%, and 94.64%, which were significantly higher than 82.14%, 76.79%, 79.62% of AFP and 82.14%, 75.00%, and 77.68% of PIVKA-Ⅱ(P<0.05). Conclusion AFP and PIVKA-Ⅱ have high diagnostic positive rates for primary liver cancer, and their combined detection has high specificity and accuracy, which can improve the diagnostic value of primary liver cancer.
作者
陈泽衍
陈晓静
郑文斌
兰希
郭伟权
黄汉莲
马雯
CHEN Ze-yan;CHEN Xiao-jing;ZHENG Wen-bin;LAN Xi;GUO Wei-quan;HUANG Han-lian;MA Wen(Department of Clinical Laboratory,Shenzhen Hospital of Southern Medical University,Shenzhen 518110,Guangdong,CHINA;Department of Clinical Laboratory,General Hospital of Shenzhen University,Shenzhen 518055,Guangdong,CHINA)
出处
《海南医学》
CAS
2020年第10期1232-1234,共3页
Hainan Medical Journal
基金
广东省自然科学基金(编号:2018A0303130119)。
关键词
原发性肝癌
异常凝血酶原
甲胎蛋白
诊断价值
敏感度
特异度
Primary liver cancer
Abnormal thrombin
Alpha-fetoprotein
Diagnostic value
Sensitivity
Specificity
