摘要
目的探讨甲胎蛋白(AFP)、异常凝血酶原(PIVKA-Ⅱ)、中性粒细胞与淋巴细胞比值(NLR)在诊断HBV相关肝细胞癌(HCC)中的应用价值。方法选取2020年7月-2021年7月在玉林市红十字会医院住院的418例与HBV相关病例作为研究对象,其中肝细胞癌组138例(HCC组),肝硬化(LC)组140例(LC组),慢性肝炎(CHB)组140例(CHB组),选择同期健康体检者150名(对照组)。治疗前进行AFP、PIVKA-Ⅱ、中性粒细胞、淋巴细胞检测。比较AFP、PIVKA-Ⅱ、NLR 3个指标在各组中的浓度分布及单独诊断HCC的阳性率。采用受试者工作曲线(ROC)评价AFP、PIVKA-Ⅱ、NLR 3个指标单独及联合诊断HCC的效能。结果HCC组AFP、PIVKA-Ⅱ表达水平均高于LC组、CHB组及对照组,差异有统计学意义(P均<0.05),HCC组、LC组、CHB组NLR表达水平均高于对照组,差异有统计学意义(P均<0.05),但HCC组、LC组、CHB组组间差异无统计学意义(P均>0.05)。HCC组PIVKA-Ⅱ诊断HCC阳性率高于AFP及NLR,差异有统计学意义(P均<0.05),AFP与NLR诊断阳性率相近,差异无统计学意义(P>0.05)。HCC组、LC组、CHB组三组间鉴别诊断HCC,单项检测PIVKA-Ⅱ的AUC最大(0.852)、敏感度最高(0.732),AFP的特异度最高(0.993),联合检测可提高诊断效能,AUC为0.869。结论AFP、PIVKA-Ⅱ、NLR单独或联合检测诊断肝细胞癌有较好的价值。AFP、PIVKA-Ⅱ检测在HBV相关HCC、LC、CHB中鉴别诊断HCC有一定价值,二者联合检测可提高诊断效能。
Objective To explore the application value of alpha-fetoprotein(AFP),prothrombin induced by vitamin K absenceⅡ(PIVKA-Ⅱ)and neutrophil to lymphocyte ratio(NLR)in the diagnosis of HBV-related hepatocellular carcinoma(HCC).MethodsA total of 418 hospitalized patients related to HBV in Red Cross Hospital of Yulin city from July,2020to July,2021 were selected as the research objects,including 138 patients in the hepatocellular carcinoma group(HCC group),140 patients in the liver cirrhosis(LC)group(LC group)and 140 patients in the chronic hepatitis B(CHB)group(CHB group);150 health checkers were selected as the healthy control group(Control group).Before treatment,AFP,PIVKA-Ⅱ,neutrophils,and lymphocytes were tested.Compare the concentration distribution of AFP,PIVKA-Ⅱand NLR in each group and the positive rate of HCC diagnosis alone.The receiver operating curve(ROC)was used to evaluate the efficacy of AFP,PIVKA-Ⅱand NLR in diagnosing HCC alone and in combination.ResultsThe expression levels of AFP and PIVKA-Ⅱin HCC group were significantly higher than those in LC group,CHB group and Control group(all P<0.05).The expression levels of NLR in the HCC group,the LC group and the CHB group were significantly higher than those in the Control group(all P<0.05).However,there was no significant difference among the HCC group,LC group and CHB group(all P>0.05).The positive rate of PIVKA-Ⅱin the diagnosis of HCC in the HCC group was significantly higher than that of AFP and NLR(both P<0.05).The positive rates of AFP and NLR were similar,and the difference was not statistically significant(P>0.05).In the differential diagnosis of HCC among the HCC group,the LC group and the CHB group,the single detection of PIVKA-Ⅱhad the highest AUC(0.852)and the highest sensitivity(0.732);the single detection of AFP had the highest specificity(0.993).Combined detection could improve the diagnostic efficiency with the AUC of 0.869.ConclusionsAFP,PIVKA-Ⅱand NLR had good value in the diagnosis of hepatocellular carcinoma alone or in
作者
赵凤华
马德佳
李山
ZHAO Feng-hua;MA De-jia;LI Shan(The First Clinical Medical College of Guangxi Medical University,Nanning,Guangxi 530021;Department of Laboratory Medicine,Red Cross Hospital of Yulin city,Yulin,Guangxi 537000,China)
出处
《热带医学杂志》
CAS
2022年第5期681-684,694,共5页
Journal of Tropical Medicine
基金
玉林市科技研究与技术开发计划项目(玉市科20204322)
