摘要
目的探讨AFP联合GGT/AST在HBV相关肝细胞癌(HCC)中的临床诊断价值。方法选取2019年1月15日—6月15日于武汉大学人民医院诊治的慢性乙型肝炎患者(CHB组)、乙型肝炎肝硬化患者(LC组)、HBV相关HCC患者(HCC组)和健康体检者(HC组)共352例,其中HC组86例,CHB组68例,LC组69例,HCC组129例,回顾性分析所有研究对象血清学检测数据。正态分布计量资料多组间比较采用方差分析,进一步两两比较采用LSD-t检验。偏态分布计量资料多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Nemenyi法检验。通过二元logistic回归分析计算出预测变量,并绘制AFP、GGT/AST以及预测变量单独或联合检测的受试者工作特征曲线(ROC曲线),计算曲线下面积(AUC)及敏感度、特异度,采用Z检验对AUC进行比较。结果HCC组GGT/AST和AFP水平均显著高于其他组(P值均<0.05)。ROC曲线分析结果显示,在HCC组与LC组、HCC组与HC组+CHB组+LC组、HCC组与CHB组+LC组中,AFP与GGT/AST联合诊断的AUC均明显高于AFP单独诊断的AUC(Z值分别为2.684、2.241、2.415,P值分别为0.007、0.025、0.016)。结论AFP联合GGT/AST可提高HBV相关HCC的临床诊断性能,具有一定诊断价值。
Objective To investigate the clinical value of alpha-fetoprotein(AFP)combined with gamma-glutamyl transpeptidase(GGT)/aspartate aminotransferase(AST)ratio in the diagnosis of hepatitis B virus(HBV)-associated hepatocellular carcinoma(HCC).Methods A total of 352 subjects who received treatment or underwent physical examination in Renmin Hospital of Wuhan University from January 15 to June 15,2020,were enrolled,among whom there were 86 healthy controls(HC group),68 patients with chronic hepatitis B(CHB group),69 patients with liver cirrhosis(LC group),and 129 patients with HCC(HCC group),and a retrospective analysis was performed for the serological test results of all subjects.An analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups;the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups,and the Nemenyi method was used for further comparison between two groups.A binary logistic regression analysis was used to calculate predictor variables;a receiver operating characteristic(ROC)curve was plotted for AFP,GGT/AST,and the predictor variables used alone or in combination,and the area under the ROC curve(AUC),sensitivity,and specificity were calculated;the Z test was used for comparison of AUC.Results The HCC group had significantly higher GGT/AST ratio and AFP than the other groups(all P<0.05).The ROC curve analysis showed that AFP combined with GGT/AST ratio had a significantly higher AUC than AFP alone in the HCC group vs the LC group,the HCC group vs the HC+CHB+LC groups,and the HCC group vs the CHB+LC groups(Z=2.684,2.241,and 2.415,P=0.007,0.025,and 0.016).Conclusion AFP combined with GGT/AST ratio can improve the clinical diagnostic performance of HBV-related HCC and thus has a certain diagnostic value.
作者
蔡馨
陈娟娟
汤冬玲
张平安
CAI Xin;CHEN Juanjuan;TANG Dongling;ZHANG Ping’an(Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China)
出处
《临床肝胆病杂志》
CAS
北大核心
2021年第9期2109-2112,共4页
Journal of Clinical Hepatology
基金
国家自然科学基金(81773444)
湖北省自然科学基金(2019CFC846)。
