摘要
分别在全自动免疫分析仪(化学发光法)和全自动电化学发光免疫分析仪(电化学发光法)上测定手术前的100例肝细胞癌患者、68例肝硬化和22例慢性乙肝患者以及100例健康体检者的PVKIA-Ⅱ和AFP的血清水平,探讨其与AFP单项及联合检测在肝细胞癌的诊断价值。结果显示肝细胞癌患者PVKIA-Ⅱ和AFP的血清水平分别与肝硬化、慢性乙肝患者和正常对照组比较,差异均有统计学意义(P<0.01)。以试剂盒参考值为诊断点时,PVKIA-Ⅱ在肝细胞癌的敏感性和特异性分别为94%和88.9%,均高于AFP(76%和88.4%)。PVKIA-Ⅱ的敏感性与肝癌患者的临床分期显著相关,随着分期的升高而升高。在Ⅰ期的肝细胞癌患者中,PVKIA-Ⅱ和AFP的敏感性均为66.7%,而二者联合检测的敏感性达到88.9%。PVKIA-Ⅱ和AFP单项和联合检测的ROC曲线下面积分别为0.948、0.906和0.961,以约登指数为诊断点时,PVKIA-Ⅱ检测的敏感性和特异性分别为96.0%和88.9%,高于AFP(86.0%和83.7%)。以单变量统计分析治疗前PVKIA-Ⅱ在不同临床特征的肝细胞癌中的表达。结果表明PVKIA-Ⅱ表达敏感性在不同肿块大小和数量的肝癌患者中差异有统计学意义(P<0.05),而在不同年龄、性别、发现肝癌途径、表面抗原状态、合并肝硬化情况、门脉瘤栓及转移情况以及AFP水平的患者中的表达敏感性差异无统计学意义。AFP阴性肝癌患者PVKIA-Ⅱ敏感性达92%。因此,化学发光法检测PVKIA-Ⅱ在肝细胞癌的筛查、早期诊断、预后判断方面具有良好的临床运用价值,其与AFP联合检测可提高肝细胞癌的早期诊断效率。
The serum levels of the abnormal prothrombin PVKIA-Ⅱ and AFP in 100 cases of hepatocellular carcinoma（HCC） before surgery, 90 patients with benign liver diseases and 100 healthy volunteers were examined by automated immunoassay an- alyzer （chemiluminescent enzyme immunoassay） and automatic electrochemiluminescence immunoassayanalyzer （ECLIA） . The results showed that there were significant differences in the serum levels of PVKIA-Ⅱ and AFP between patients with HCC and those with benign liver diseases and normal controls, and the difference was statistically significant （P 〈0.01）. Sensitivity and specificity of PVKIA-Ⅱ were 94% and 88.9% respectively in HCC, both higher than those of AFP （76% and 88.4%）, and sensitivity of PVKIA-Ⅱ increased with stages of HCC. The sensitivity of PVKIA-Ⅱ and AFP in stage Ⅰ HCC was 66.7% respectively, while the sensitivity of a joint detection increased to 88.9%. The AUC^ROC of individual detection of PVKIA-Ⅱ and AFP and joint detection of PVKIA- Ⅱ and AFP were 0. 948, 0. 906 and 0. 961. When the Youden index was taking as diagnostic points, the sensitivity and specificity of PVKIA-Ⅱ were 96% and 88.9% respectively in HCC, higher than those of AFP （86% and 83.7%）. The expression of PVKIA-Ⅱ varied with tumor mass and number in HCC patients, but irrelevant to age gender of the patients and the way cancer was found, surface antigen status, coexistence of liver cirrhosis , portal vein tumor thrombus, metastasis and AFP levels. The sensitivity of PVKIA-Ⅱ was 92% in AFP-negative HCC patients. Therefore, PVKIA-Ⅱ detected by chemiluminescence had good value in screening, early diagnosis and prognosis of HCC, and its joint detection with AFP could greatly improve the efficiency of early diagnosis of HCC.
出处
《现代免疫学》
CAS
CSCD
北大核心
2015年第4期328-333,327,共7页
Current Immunology
基金
国家临床重点专科建设项目
关键词
异常凝血酶原
甲胎蛋白
肝细胞癌
诊断
联合检测
abnormal prothrombin
fetoprotein
hepatoeellular carcinoma
diagnosis
joint detection
