摘要
目的探讨肝癌患者血清γ谷氨酰氨转肽酶(γ-GT)、球蛋白(GLB)、白蛋白(ALB)、总胆固醇(CHOL)及甲胎蛋白(AFP)水平变化及其临床意义。方法回顾性分析2014年1月至2016年6月间收治的86例原发性肝癌(PHC)患者(PHC组)临床资料,并纳入同期收治的40例肝硬化患者(肝硬化组)、30例体检健康者(对照组)资料。比较各组γ-GT、GLB、ALB、CHOL、AFP水平,评估PHC不同肝功能者(Child-Pugh)中、γ-GT、GLB、ALB、CHOL、AFP水平,绘制ROC曲线评估各指标单独及联合检测诊断PHC效能。记录患者预后,评估各指标与患者生存期的关系。结果①γ-GT、GLB、AFP均高于对照组(P<0.05),PHC组和肝硬化组CHOL、ALB均低于对照组(P<0.05),PHC组γ-GT、GLB、AFP均高于肝硬化组(P<0.05),PHC组CHOL均低于肝硬化组(P<0.05),PHC组ALB和肝硬化组对比差异无统计学意义(P>0.05);②Child-PughA、B级者γ-GT、GLB、AFP水平均低于Child-Pugh C级者(P<0.05),Child-PughA、B级者CHOL、ALB水平高于Child-PughC级者(P<0.05);③各指标单独诊断PHC的AUC最高的是AFP,联合诊断AUC高于各指标单独诊断;④PHCⅢ期患者γ-GT、GLB、AFP、ALB正常者生存时间均长于异常者(P<0.05),CHOL正常者、异常者生存时间对比差异无统计学意义(P>0.05);PHC IV期患者γ-GT、GLB、AFP正常者生存时间均长于异常者(P<0.05),CHOL、ALB正常者、异常者生存时间对比差异无统计学意义(P>0.05)。结论肝癌患者γ-GT、GLB、AFP水平增高,CHOL、ALB水平降低,各血清指标检测有利于PHC患者鉴别诊断和预后预测。
Objective To explore the changes and clinical significance of serumγ-glutamyltransferase(γ-GT),globulin(GLB),albumin(ALB),total cholesterol(CHOL)and alpha-fetoprotein(AFP)levels in patients with hepatocellular carcinoma.Methods The clinical data of 86 patients with primary hepatocellular carcinoma(PHC)(the PHC group)admitted from January,2014 to June,2016 were retrospectively analyzed,and 40 patients with cirrhosis(the cirrhosis group)and 30 healthy examiners(the control group)were included as controls.The levels ofγ-GT,GLB,ALB,CHOL and AFP in each group were measured and compared among groups.The levels ofγ-GT,GLB,ALB,CHOL and AFP were evaluated among patients with different liver function(Child-Pugh).ROC curve was drawn to evaluate the efficacy of single detection and combined detection of indicators on PHC.The prognosis was recorded.The relationship between each indicator and patient survival time was evaluated.Results The levels ofγ-GT,GLB and AFP were higher than those in the control group(P<0.05),while the levels of CHOL and ALB in the PHC group and cirrhosis group were lower than those in the control group(P<0.05),and the levels ofγ-GT,GLB and AFP in the PHC group were higher than those in the cirrhosis group(P<0.05),while the level of CHOL in the PHC group was lower than that in the cirrhosis group(P<0.05),and there was no significant difference in the ALB between the PHC group and cirrhosis group(P>0.05).The levels ofγ-GT,GLB and AFP of patients with Child-Pugh grade A and Child-Pugh grade B were lower than those of patients with Child-Pugh grade C(P<0.05),while the levels of CHOL and ALB of patients with Child-Pugh grade A and Child-Pugh grade B were higher than those of patients with Child-Pugh grade C(P<0.05).The highest AUC of each indicator for the diagnosis of PHC was AFP.The AUC of combined diagnosis was higher than that of each individual indicator.The survival time of PHCⅢstage patients with normalγ-GT,GLB,AFP and ALB was longer than that of abnormal patients(P<0.05),and there was no s
作者
任书勤
章阳
REN Shuqin;ZHANG Yang(Department of Gastroenterology,416 Hospital of Nuclear Industry,Second Affiliated Hospital ofChengdu Medical College,Chengdu 610051,China)
出处
《标记免疫分析与临床》
CAS
2020年第3期398-404,共7页
Labeled Immunoassays and Clinical Medicine
关键词
肝癌
γ谷氨酰氨转肽酶
球蛋白
白蛋白
总胆固醇
甲胎蛋白
Hepatocellular carcinoma
γ-glutamyltransferase
Globulin
Albumin
Total cholesterol
Alpha-fetoprotein
