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投稿时间:2023-08-15 网络发布日期:2024-08-20
投稿时间:2023-08-15 网络发布日期:2024-08-20
中文摘要: 目的 构建预测模型分析血清甲胎蛋白(AFP)、癌胚抗原(CEA)、热休克蛋白90a(Hsp90a)等指标对原发性肝癌(PHC)的诊断价值。方法 回顾性选取保定市第二医院2020年3月至2021年12月收治的72例PHC患者(PHC组),68例慢性肝病患者(慢性肝病组),及同期50例健康受试者(健康对照组)为研究对象,采用化学发光法检测血清AFP、CEA水平,采用酶联免疫吸附法检测血清Hsp90a水平,受试者工作特征(ROC)曲线及曲线下面积(AUC)分析各指标对PHC的诊断效能,多因素Cox风险回归分析发生PHC的独立因素,R软件“rms”包构建预测模型并进行验证。结果 三组AFP、CEA及Hsp90a水平差异有统计学意义,PHC组最高,对照组最低,且两两比较差异有统计学意义(P<0.05)。AFP(OR=1.770,95%CI:1.137~2.756)、CEA(OR=2.651,95%CI:1.168~6.015)、Hsp90a(OR=1.402, 95%CI:1.141~1.723)是PHC的独立危险因素(P<0.05)。AFP、CEA及HSP90单独预测PHC的AUC分别为0.929、0.947、0.899。构建的联合预测模型的C-index为0.669(0.647~0.831)。结论 基于AFP、CEA及Hsp90a指标构建的模型对PHC具有较高的诊断价值,可在临床用于早期的PHC筛查。
Abstract:Objective To construct a predictive model to analyze the diagnostic value of serum alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), heat shock protein 90a (Hsp90a) for primary liver cancer (PHC). Methods A retrospective study was conducted on 72 patients with PHC (PHC group), 68 patients with chronic liver disease (chronic liver disease group), and 50 healthy subjects (healthy control group) admitted to The No.2 Hospital of Baoding from March 2020 to December 2021. Serum AFP and CEA levels were detected using chemiluminescence, serum Hsp90a levels were detected using enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to evaluate the diagnostic efficacy of each indicator for PHC. Multivariate Cox risk regression analysis was used to identify independent factors for the occurrence of PHC. A predictive model was constructed and validated by R software. Results The differences in AFP, CEA and Hsp90a levels among the three groups were statistically significant, with the highest in the PHC group and the lowest in the control group, and the difference was statistically significant in a pairwise comparison (P<0.05). AFP (OR=1.770, 95%CI: 1.137-2.756), CEA (OR=2.651, 95%CI: 1.168-6.015), and Hsp90a (OR=1.402, 95%CI: 1.141-1.723) were independent risk factors for PHC (P<0.05). The AUC of AFP, CEA, and HSP90 predicting PHC separately were 0.929, 0.947, and 0.899, respectively. The C-index of the constructed joint prediction model was 0.669 (0.647-0.831). Conclusion The model based on AFP, CEA and HSP90a has high diagnostic value for patients with PHC, and it can be used for early PHC screening in clinic.
keywords: Primary liver cancer Alpha fetoprotein Carcinoembryonic antigen Heat shock protein Prediction model
文章编号: 中图分类号:R735.7 文献标志码:A
基金项目:保定市科技计划自筹经费项目(2141ZF011)
Author Name | Affiliation |
WANG Yanpeng, LIU Juanjuan, JIA Cun, LI Jing | Department of Medical Laboratory, The No.2 Hospital of Baoding, Baoding, Heibei 071051, China |
引用文本:
王彦鹏,刘娟娟,贾存,李静.构建预测模型分析AFP、CEA、Hsp90a对原发性肝癌的诊断价值[J].中国临床研究,2024,37(8):1244-1248.
王彦鹏,刘娟娟,贾存,李静.构建预测模型分析AFP、CEA、Hsp90a对原发性肝癌的诊断价值[J].中国临床研究,2024,37(8):1244-1248.