摘要
目的探讨载脂蛋白A1、碱性磷酸酶等指标在HBV相关肝癌中的变化,分析甲胎蛋白(AFP)联合其他指标对提高HBV相关肝癌诊断效能的临床价值。方法收集慢性乙型肝炎、乙型肝炎后代偿性肝硬化、乙型肝炎后肝硬化失代偿和慢性乙型肝炎相关肝癌患者共1089例。其中非肝癌患者(非肝癌组)745例、HBV相关肝癌(肝癌组)344例。使用单因素和多因素的Logistic回归分析HBV相关肝癌影响因素,采用受试者操作特征曲线下面积(ROC AUC)评估AFP联合其他血清学指标对HBV相关肝癌的诊断效能。结果血清载脂蛋白A1、碱性磷酸酶、AFP等血清学指标在非肝癌组和肝癌组间比较差异有统计学意义(P均<0.05)。多因素Logistic回归分析显示性别、年龄、AFP、载脂蛋白A1、碱性磷酸酶为HBV相关肝癌的影响因素(P均<0.05);这些指标形成联合模型诊断HBV相关肝癌的ROC AUC为0.859,而单独甲胎蛋白诊断HBV相关肝癌的ROC AUC为0.750,联合模型的诊断效能高于单独AFP的诊断效能(P<0.05)。结论血清AFP和载脂蛋白A1、碱性磷酸酶等指标的联合模型较单独AFP的诊断效能有所提高,对HBV相关肝癌的辅助诊断具有一定的价值。
Objective To investigate the changes of apolipoprotein A1(ApoA1)and alkaline phosphatase in hepatitis B virus(HBV)-related liver cancer,and evaluate the diagnostic performance of alpha-fetoprotein(AFP)combined with other indexes for HBV-related liver cancer.Methods 1089 patients with chronic hepatitis B,compensated cirrhosis,non-compensated cirrhosis post-hepatitis B and chronic B-related liver cancer were enrolled.Among them,745 cases were included in non-liver cancer group,and 344 cases in the HBV-related liver cancer group(liver cancer group).The influencing factors of HBV-related liver cancer were identified by univariate and multivariate Logistic regression analyses.The area under the receiver operating characteristic(ROC)curve(AUC)was adopted to evaluate the diagnostic efficacy of AFP combined with other serological indexes in HBV-related liver cancer.Results Significant differences were observed in serum levels of ApoA1,alkaline phosphatase and AFP between the non-liver cancer and liver cancer groups(all P<0.05).Multivariate Logistic regression analysis showed that sex,age,AFP,ApoA1 and alkaline phosphatase were the influencing factors of HBV-related liver cancer(all P<0.05).The AUC of the model consisting of these indexes combined for HBV-related liver cancer was 0.859,and 0.750 for AFP alone,indicating the model of these indexes combined yielded significantly higher diagnostic efficacy compared with AFP alone(P<0.05).Conclusions The model consisting of serum AFP,ApoA1 and alkaline phosphatase yields higher diagnostic efficacy than AFP alone.It possesses certain value for auxiliary diagnosis of HBV-related liver cancer.
作者
李媚
刘敏思
黄月华
许颖君
Li Mei;Liu Minsi;Huang Yuehua;Xu Yingjun(Guangdong Provincial Key Laboratory of Liver Disease Research,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)
出处
《新医学》
CAS
2023年第9期671-675,共5页
Journal of New Medicine
关键词
甲胎蛋白
载脂蛋白A1
慢性乙型肝炎
原发性肝癌
Alpha-fetoprotein
Apolipoprotein A1
Chronic hepatitis B
Primary liver cancer
