甲胎蛋白异质体比率和血清异常凝血酶原联合检测对肝细胞癌的临床

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甲胎蛋白异质体比率和血清异常凝血酶原联合检测对肝细胞癌的临床诊断价值

作者:王秀丽黄清勇吴玉英

来源:《中外医学研究》2020年第06期

【摘要】目的:探讨甲胎蛋白异质体比率(AFP-L3%)和血清异常凝血酶原(Pivka-Ⅱ)联合检测对肝细胞癌的临床诊断价值。方法:选择笔者所在医院于2018年3月-2019年5月收治的肝细胞癌患者83例(肝细胞癌组),慢性乙型肝炎患者147例(慢性乙型肝炎

组),原发性胆汁性肝硬化患者32例(原发性胆汁肝硬化组)。比较三组AFP、Pivka-Ⅱ和AFP-L3%水平,分析AFP、Pivka-Ⅱ和AFP-L3%单项检测与联合检测的诊断价值,并对肝细胞癌组Pivka-Ⅱ和AFP-L3%阳性率情况进行统计。结果:肝细胞癌组AFP、AFP-L3%和Pivka-Ⅱ水平均显著高于慢性乙型肝炎组和原发性胆汁肝硬化组,差异均有统计学意义

(P<0.05);AFP、Pivka-Ⅱ和AFP-L3%联合检测在肝细胞癌患者中的灵敏度、特异度均高于AFP、Pivka-Ⅱ和AFP-L3%单项检测,差异均有统计学意义(P<0.05);阳性低浓度组和阳性高浓度组AFP-L3%和Pivka-Ⅱ阳性率均高于阴性组,差异均有统计学意义(P<0.05);阳性低浓度组和阳性高浓度组AFP-L3%和Pivka-Ⅱ阳性率比较,差异均无统计学意义(P>0.05)。结论:甲胎蛋白异质体比率和血清异常凝血酶原联合检测对肝细胞癌具有较高的临床诊断价值。

【关键词】甲胎蛋白异质体比率血清异常凝血酶原肝细胞癌

[Abstract] Objective: To investigate the clinical diagnostic value of combined detection of alpha-fetoprotein heterogenous ratio (AFP-L3%) and serum abnormal prothrombin (Pivka-Ⅱ)in hepatocellular carcinoma. Method: A total of 83 patients with hepatocellular carcinoma (the hepatocellular carcinoma group), 147 patients with chronic hepatitis B (the chronic hepatitis B group) and 32 patients with primary biliary cirrhosis (the primary biliary cirrhosis group)admitted to our hospital from March 2018 to May 2019 were selected. The levels of AFP, Pivka-Ⅱand AFP-L3% were compared among three groups, and the diagnostic value of single and combined detection of AFP, Pivka-Ⅱ and AFP-L3% were analyzed, and the positive rates of Pivka-Ⅱ and AFP-L3% in the hepatocellular carcinoma group were compared. Result: The levels of AFP, AFP-L3% and Pivka-Ⅱ in the hepatocellular carcinoma group were significantly higher than those of the chronic hepatitis B group and primary biliary cirrhosis group, and the differences were significant (P<0.05). The sensitivity and specificity of combined detection of AFP, Pivka-Ⅱ and AFP-L3% were higher than those of single detection of AFP, Pivka-Ⅱ and AFP-L3%, and the differences were significant (P<0.05). The positive rates of AFP-L3% and Pivka-Ⅱ in the positive low concentration group and the positive high concentration group were higher than those of the negative group, and the differences were significant (P<0.05). The positive rates of AFP-L3% and Pivka-Ⅱ between the positive low concentration group and positive high concentration group were compared, and the differences were not statistically significant (P>0.05). Conclusion: The combined detection of alpha-fetoprotein heterogenous ratio and serum abnormal prothrombin is of great value in the clinical diagnosis of hepatocellular carcinoma.

肝細胞癌是一种死亡率高的原发性肝癌,由于早期临床症状不显著,直至中晚期才会表现出腹痛、腹胀、发热、体重减轻等症状,因此治疗难度较高[1]。肝细胞癌的病程进展较快、转移率和复发率均较高,在目前的临床治疗中,肝移植是最有效的治疗手段,但临床效果和预后都较差[2]。若能尽早做出确切诊断,在癌症早期即给予针对性的有效治疗,争取治疗

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