摘要
目的探讨异常凝血酶原(PIVKA-Ⅱ)和甲胎蛋白(AFP)在原发性肝癌(PHC)中的诊断价值。方法回顾性分析108例PHC、100例肝硬化、89例慢性肝炎、76例继发性肝癌及84例健康体检者的临床资料,所有研究对象均检测血清PIVKA-Ⅱ与AFP水平。比较各组研究对象血清PIVKA-Ⅱ与AFP水平,并采用受试者工作特征(ROC)曲线评价PIVKA-Ⅱ及AFP对PHC的诊断效能。结果 PHC患者PIVKA-Ⅱ与AFP水平均高于非PHC肝病患者及健康体检者(均P <0. 05),且中晚期PHC患者PIVKA-Ⅱ与AFP水平均高于早期PHC患者(均P <0. 05)。不同病因PHC患者AFP水平差异无统计学意义(P> 0. 05),但肝炎合并酒精性PHC患者PIVKA-Ⅱ水平均低于病毒性肝炎性PHC与酒精性PHC患者(均P <0. 05),病毒性肝炎性PHC与酒精性PHC患者PIVKA-Ⅱ水平差异无统计学意义(P> 0. 05)。PIVKA-Ⅱ、AFP、PIVKA-Ⅱ联合AFP诊断PHC的ROC曲线下面积分别为0. 928、0. 871、0. 963,PIVKA-Ⅱ联合AFP诊断PHC的曲线下面积大于PIVKA-Ⅱ及AFP(P <0. 05)。结论 PIVKA-Ⅱ联合AFP检测在PHC中具有较高的诊断价值。
Objective To investigate the diagnostic value of abnormal prothrombin[protein induced by vitamin K absence or antagonistⅡ(PIVKA-Ⅱ)]and alpha-fetoprotein(AFP)in primary hepatic carcinoma(PHC).Methods The clinical data of 108 patients with PHC,100 patients with cirrhosis,89 patients with chronic hepatitis,76 patients with secondary hepatocellular carcinoma and 84 healthy persons undergoing a check-up were analyzed retrospectively.The serum levels of PIVKA-Ⅱand AFP of the subjects were compared among all groups.The diagnostic efficiency of PIVKA-Ⅱand AFP for PHC was evaluated by the receiver operating characteristic(ROC)curve as well.Results The levels of PIVKA-Ⅱand AFP in the patients with PHC were higher than those in the patients with liver disease but without PHC or in the healthy subjects(all P<0.05),and the levels of PIVKA-Ⅱand AFP in the patients with advanced PHC were higher than those in the patients with early PHC(all P<0.05).There was no statistically significant difference in the AFP level among the PHC patients with different etiologies(P>0.05),but the PIVKA-Ⅱlevel in the hepatitis patients complicated with alcoholic PHC was lower than that in the patients with viral hepatitis PHC or alcoholic PHC(all P<0.05),there was no statistically significant difference in the PIVKA-Ⅱlevel between the patients with viral hepatitis PHC and the patients with alcoholic PHC(P>0.05).The areas of ROC curve of PIVKA-Ⅱ,AFP and their combination for diagnosing PHC were 0.928,0.871 and 0.963 respectively,and the area of PIVKA-Ⅱcombined with AFP for diagnosing PHC was greater than that of PIVKA-Ⅱor AFP(P<0.05).Conclusion The combined detection of PIVKA-Ⅱand AFP has a higher diagnostic value for PHC.
作者
付彪
吕沐瀚
唐世孝
FU Biao;LYU Mu-hai;TANG Shi-xiao(School of Clinical Medicine,Southwest Medical University,Luzhou 646000,China;Department of Gastroenterology,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)
出处
《广西医学》
CAS
2018年第19期2268-2271,共4页
Guangxi Medical Journal
基金
四川省泸州市人民政府-四川医科大学科技战略合作项目[2015LZCYD-S01(9/15)]
关键词
原发性肝癌
异常凝血酶原
甲胎蛋白
诊断
Primary liver cancer
Abnormal prothrombin
Alpha fetoprotein
Diagnosis
