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Received:May 12, 2023 Published Online:September 19, 2023
Received:May 12, 2023 Published Online:September 19, 2023
中文摘要: 目的 联合检测异常凝血酶原(DCP)、高尔基体蛋白-73(GP73)以及α-羟丁酸脱氢酶(α-HBDH),评估其单独及联合检测对甲胎蛋白(AFP)阴性原发性肝癌(PHCC)的诊断价值。方法 回顾性选取2021年1月至2022年12月在南京市第二医院就诊的AFP阴性PHCC患者88例(肝癌组)、肝炎肝硬化患者84例(肝硬化组)、慢性乙型肝炎患者75例(肝炎组)和健康对照者67例(健康对照组),所有患者均有HBV感染。检测并比较四组对象血清DCP、GP73及α-HBDH水平,绘制受试者操作特征曲线(ROC)分析三项指标单独及联合检测对AFP阴性PHCC的诊断效能。结果 肝癌组患者DCP、GP73、α-HBDH水平分别高于肝硬化组、肝炎组及健康对照组(P<0.05)。在AFP阴性PHCC诊断中,联合检测的ROC曲线下面积(AUC)(0.889),分别高于DCP(0.804)、GP73(0.748)和α-HBDH(0.800)各单项检测,差异有统计学意义(Z =3.078、3.350、3.042,P<0.01)。单项检测以DCP的灵敏度(56.82%)、特异度(91.82%)、准确度(79.35%)最高;而联合检测的灵敏度、特异度、准确度更高,分别是92.04%、96.03%、91.09%。结论 在AFP阴性PHCC的诊断中,DCP、GP73、α-HBDH均有一定意义,联合检测有助于提高诊断效能。
Abstract:Objective To evaluate the diagnostic value of abnormal prothrombin (des-gamma-carboxy prothrombin, DCP), Golgi protein 73 (GP73) and α-hydroxybutyrate dehydrogenase (α-HBDH) in the patients with alpha-fetoprotein(AFP)-negative primary hepatocellular carcinoma (PHCC). Methods A retrospective analysis was conducted on the patients with hepatitis B virus (HBV) infection treated in Second Hospital of Nanjing from January 2021 to December 2022, including 88 PHCC patients with negative AFP (PHCC group), 84 patients with hepatitis cirrhosis (cirrhosis group) and 75 patients with chronic hepatitis B (hepatitis group). At the same time, 67 healthy persons were served as control group. The serum DCP, GP73 and α-HBDH levels were detected and compared among these groups to assess the diagnostic efficacy of the three indicators (alone or in combination) for AFP-negative PHCC by drawing receiver operating characteristic (ROC) curve. Results The levels of DCP, GP73 and α-HBDH in PHCC group were significantly higher than those in cirrhosis group, hepatitis group and control group (P<0.05), respectively. In the diagnosis of AFP-negative PHCC, the area under ROC (AUC) of combined detection of DCP, GP73 and α-HBDHwas 0.889, which was higher than that of DCP (0.804), GP73 (0.748) and α-HBDH (0.800) individually, and there were significant differences (Z =3.087, 3.350, 3.042, P<0.01). The sensitivity (92.04%), specificity (96.03%) and accuracy (91.09%) of combined detection were the highest, followed by those of alone DCP (56.82%, 91.82%, 79.35%, respectively). Conclusion DCP, GP73 and α-HBDH have certain value in diagnosing AFP-negative PHCC, and the combined detection is helpful to improve the diagnostic efficiency.
keywords: Primary hepatocellular carcinoma Negative alpha-fetoprotein Des-gamma-carboxy prothrombin Golgi protein 73 α-hydroxybutyrate dehydrogenase
文章编号: 中图分类号:R735.7 文献标志码:A
基金项目:江苏省自然科学基金项目(BK20161110)
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