摘要
目的通过Fibro Scan检测肝脏硬度对原发性肝癌(primary liver cancer,PLC)的诊断价值。方法选取延安市中医医院2014年12月—2016年1月收治的肝硬化(liver cirrhosis,LC)、PLC患者各285例,根据患者疾病种类的不同,将患者分为PLC组和LC组,比较2组患者Fibro Scan检查、血清标志物检测结果,分析Fibro Scan检测对原发性肝癌的诊断价值。结果 2组患者年龄、碱性磷酸酶(alkaline phosphatase,ALP)、谷氨酰转肽酶(glutamyl transpeptidase,GGT)、天冬氨酸转氨酶血小板比值指数(aspartate aminotransferase and platelet ratio,APRI)、总胆红素(total bilirubin,TBIL)、血清白蛋白(albumin,ALB)、外周动脉张力(peripheral arterial tonometry,PAT)、肝硬度(liver stiffness,LS)比较,差异具有统计学意义(P<0.05),经多因素Logistic回归结果显示,患者年龄、GGT、APRI、LS、AFP是影响PLC发生的独立危险因素,数据差异具有统计学意义(P<0.001);LC组患者LS平均值明显低于PLC组(P<0.05);LS其标准误差为0.008,95%CI为0.876~0.914,其诊断其准确率明显高于TBIL、ALP、GGT、AFP、APRI(P<0.05),16.89 k Pa是LS诊断PLC的最佳临界值,灵敏度、特异度分别为81.21%及80.96%。在设置特异度>90%为条件时其LS值为23.69 k Pa,灵敏度为66.01%,特异度90.11%。结论 Fibro Scan通过检测患者的肝脏硬度对原发性肝癌的确诊率高,值得临床运用推广。
Objective To study the diagnostic value of liver hardness in primary liver cancer detected using FibroScan. Methods 285 cases of hepatic sclerosis(LC) and another 285 cases of primary liver cancer(HCC) admitted to our hospital between December 2014 and January 2016 were selected as subjects. These patients were divided into primary liver cancer group(HCC group) and cirrhosis group(LC group) according to the types of diseases. FibroScan examination results and serum markers were compared between the two groups, and the diagnostic value of FibroScan for primary liver cancer was analyzed. Results The age of patients, ALP, GGT, APRI, TBIL, ALB, PAT, LS and AFP of the two groups were significantly different, and the difference was statistically significant(P<0.05). The multivariate logistic regression analysis showed that age, GGT, APRI, LS and AFP were independent risk factors for HCC, and the difference was statistically significant(P<0.001). The mean value of LS in LC group was significantly lower than that in HCC group(P<0.05). The standard error of LS was 0.008, the 95% CI was 0.876-0.914, and its accuracy of diagnosis was significantly higher than that of TBIL, ALP, GGT, AFP, APRI(P<0.05). 16.89 kPa was the optimal threshold for the diagnosis of HCC,and the sensitivity and specificity were 81.21% and 80.96%, respectively. The LS value was 23.69 kPa, the sensitivity was 66.01% and the specificity was 90.11% when the specificity was set to be>90%. Conclusion FibroScan has a high diagnosis rate of primary liver cancer by detecting the liver hardness of patients, which is worthy of clinical application.
出处
《空军医学杂志》
2017年第6期381-383,387,共4页
Medical Journal of Air Force
基金
陕西省科学技术研究发展计划项目(2012SF2-06-4)
