摘要
目的探讨异常凝血酶原(PIVKA-II)与血清甲胎蛋白(AFP)和乙型肝炎病毒(HBV)DNA载量的相关性,评价PIVKA-II与AFP联合检测对HBV感染相关肝细胞癌的诊断价值。方法分别采用化学发光酶免疫法、电化学发光法和荧光定量聚合酶链式反应(PCR)技术对HBV感染相关的34例肝癌患者、68例良性肝病患者(对照组)进行术前或治疗前PIVKA-Ⅱ、AFP和HBV DNA载量水平测定,探讨PIVKA-Ⅱ与AFP、HBV DNA载量的相关性,并用受试者工作特征(ROC)曲线分析AFP和PIVKA-Ⅱ联合检测在HBV感染相关肝癌诊断中的临床价值。结果肝癌组PIVKA-II、AFP和HBV-DNA裁量水平[M(P25,P75)]分别为2 861.00(166.75,25 544.50)m AU/ml、589.65(98.55,5 237.30)ng/ml和300.50(16.63,103 200.00)copies/ml,对照组PIVKA-II、AFP和HBV-DNA裁量水平分别为19.50 (2.73,153.15)m AU/ml、36.50(25.25,78.00)ng/ml和503.00(71.70,78 375.00)copies/ml,两组间PIVKA-II、AFP比较差异均有统计学意义(均P<0.05),HBV DNA载量水平比较差异无统计学意义(P>0.05)。肝癌组PIVKA-II与AFP、HBV DNA载量之间均无相关性(r=0.251、0.269,均P>0.05);对照组PIVKA-II与HBV DNA载量无相关性(r=-0.095,P>0.05),与AFP成弱正相关(r=0.261,P<0.05)。根据ROC曲线,PIVKA-II和AFP单独诊断肝癌的曲线下面积(AUC)分别为0.856和0.785,灵敏度和特异度分别为88.2%、73.5%和73.5%、72.1%;两者联合诊断肝癌的AUC为0.878,灵敏度为82.4%,特异度为80.9%。结论 PIVKA-II水平与AFP呈弱正相关性,与HBV DNA载量无相关性。PIVKA-II与AFP联合检测有助于提高HBV感染相关肝细胞癌(HCC)的检出率。
[Objective]To investigate the correlation of the abnormal prothrombin(PIVKA-Ⅱ)and serum alpha fetoprotein(AFP),hepatitis B virus(HBV)DNA load,and evaluate the diagnostic value of PIVKAⅡand AFP combined detection for HBV infection-related hepatocellular carcinoma.[Methods]By the methods of chemiluminescent enzyme immunoassay,electrochemical luminescence and fluorescent quantitative PCR technique,the level of PIVKA-Ⅱ,AFP and HBV DNA load in HBV infectionrelated 34 patients with liver cancer and 68 cases of patients with benign liver diseases(control group)were measured respectively,before their surgery or treatment to study the correlation of PIVKA-Ⅱand AFP,HBV DNA loads,and the receiver-operating characteristic(ROC)curve was used to analyze the clinical value of AFP and PIVKA-Ⅱjoint detection in the diagnosis of HBVassociated liver cancer.[Results]The levels of PIVKA-Ⅱ,AFP and HBV-DNA load in the liver cancer group[M(P25,P75)]were2 861.00(166.75,25544.50)mAU/ml,589.65(98.55,5 237.30)ng/ml and 300.50(16.63,103200.00)copies/ml,while those in the control group were 19.50(2.73,153.15)mAU/ml,36.50(25.25,78.00)ng/ml and 503.00(71.70,78 375.00)copies/ml,with significant difference of PIVKA-Ⅱ、AFP(both P<0.05),and no significant difference of HBV DNA lo ads(P>0.05).There was no correlation between PIVKA-Ⅱ,AFP and HBV DNA load in liver cancer group(r=0.251,0.269,all P>0.05).In the control group,PIVKA-Ⅱwas not correlated with HBV DNA load(r=-0.095,P>0.05),but was weakly positively correlated with AFP(r=0.261,P<0.05).According to the ROC curve,the area under the curve(AUC)of PIVKA-Ⅱand AFP separate ly diagnosed liver cancer was 0.856 and 0.785,respectively,and the sensitivity and specificity were 88.2%,73.5%,73.5%and 72.1%,respectively.The AUC of combined diagnosis of hepatocellular carcinoma was 0.878,sensitivity and specificity were 82.4%and 80.9%respectively.[Conclusion]PIVKA-Ⅱlevel is weakly positively correlated with AFP,but not with HBV DNA load.PIVKA-Ⅱcombined with AFP can improve the detectio
作者
陈娟娟
张平安
郑红云
申复进
CHEN Juan-juan;ZHANG Ping-an;ZHENG Hong-yun;SHEN Fu-jin(Laboratory Department,Renmin Hospital of Wuhan University,Wuhan Hubei,430060,China)
出处
《职业与健康》
CAS
2019年第9期1176-1179,共4页
Occupation and Health
关键词
异常凝血酶原
甲胎蛋白
肝癌
诊断
病毒载量
PIVKA-Ⅱ
Serum alpha fetoprotein
Hepatocellular carcinoma
Diagnosis
Viral load
