甲胎蛋白、Dickkopf1糖蛋白和α-L-岩藻糖苷酶在肝癌早期诊断中的应用

Value of alpha fetoprotein, Dickkopf1 glycoprotein and α-L-fucosidase in early diagnosis of liver cancer

目的:探讨甲胎蛋白(alpha fetoprotein,AFP)、Dickkopf1糖蛋白(dickkopf1,DKK1)及α-L-岩藻糖苷酶(α-L-fucosidase,AFU)在肝癌早期诊断的临床应用价值.方法:103例原发性肝癌(primary carcinoma of the liver,PCL)设为肝癌组,60例肝硬化设为肝硬化组,127例慢性乙型肝炎设为肝炎组,236例健康体检人员设为对照组.比较4组研究对象AFP、DKK1及AFU检测情况,并对3种标志物在PCL早期诊断的临床应用价值进行方法学评价.结果:肝癌组患者血清AFP、DKK1、AFU水平及异常率均高于其他各组,差异有统计学意义(P<0.05),肝硬化组患者血清AFP、DKK1及AFU水平及异常率均高于肝炎组及对照组,差异有统计学意义(P<0.05),AFP、D K K1及A F U 3种肿瘤标志物联合检测其方法学评价灵敏度为89.3%,Youden指数为0.789,阴性预测值为97.2%,相对于单独检测均有大幅提高.结论:AFP、AFU及DKK1 3种肿瘤标志物联检对方法学灵敏度有较大的提升,减少了漏诊率,在PCL的防治有较高的临床应用价值,值得推广应用.

AIM： To investigate the value of alpha fetopro-tein（AFP）, Dickkopf1 glycoprotein（DKK1） and α-L-fucosidase（AFU） in the early diagnosis of hepatocellular carcinoma（HCC）.METHODS： One hundred and three patients with primary HCC, 60 patients with liver cir-rhosis, 127 patients with chronic hepatitis B, and 236 healthy people were included in the study. AFP, DKK1 and AFU were detected and com-pared among the four groups. The value of these markers in the diagnosis of primary HCC was evaluated.RESULTS： Serum levels and abnormal rates of AFP, DKK1 and AFU were significantly higherin the HCC group than in the other groups（P〈0.05）, and in the liver cirrhosis group than in the chronic hepatitis B group and control group（P〈0.05）. Combined detection of AFP, DKK1 and AFU in the diagnosis of HCC had a sensitivity of 89.3%, a Youden index of 0.789, and a negative predictive value of 97.2%. The diagnostic accu-racy of combined detection was significantly im-proved compared to the detection of any single index.CONCLUSION： Combined detection of AFP, AFU and DKK1 has a high sensitivity in the di-agnosis of primary HCC and can reduce the rate of missed diagnosis.