血清异常凝血酶原对相关肝脏疾病的辅助诊断价值

Diagnostic value of abnormal prothrombin on Different liver diseases

目的:探讨血清异常凝血酶原(PIVKA-II)为原发性肝癌提供临床诊断和治疗依据。方法:收集2016年1月~2017年12月于湖南省人民医院就诊的529例病人资料。将529例患者依据诊断结论分为肝癌组97例,肝硬化组289例,肝炎组98例,其他肝病组45例,另随机选取118例体检正常者作为健康人对照组。通过化学发光微粒子免疫检测法检测血清异常凝血酶原浓度。结果:肝癌组血清异常凝血酶原指标显著高于肝硬化组与肝炎组;肝硬化组和肝炎组异常凝血酶原浓度没有显著差异。肝癌组,肝硬化组,肝炎组血清异常凝血酶原显著高于正常组。实验组肝细胞癌组与肝胆管癌组、胆管细胞癌组异常凝血酶原浓度无显著差异。肝癌患者手术治疗前血清异常凝血酶原指标显著高于肝癌患者治疗后组异常凝血酶原浓度。结论:原发性肝癌患者血清异常凝血酶原指标显著偏高,原发性肝癌患者手术治疗前后异常凝血酶原浓度有明显变化,异常凝血酶原对原发性肝癌的临床诊断和疗效监测具有一定的价值。

Objective To study the serum concentration of abnormal thrombin in patients with cancer and PIVKA-II before and after treatment of liver cancer,and to provide evidence for the clinical diagnosis and treatment of hepatocellular carcinoma.Methods To collect data on 529 patients treated at the People’s Hospital of Hunan Province from January 2016 to December 2017.According to the diagnosis conclusion,529 patients were divided into 97 cases of liver cancer,289 cases of liver harden group,98 cases of hepatitis group,and 45 cases of other liver diseases group.Another 118 cases of normal physical examination were randomly selected as healthy control groups.Serum abnormal prothrombin concentration was detected by chemiluminescent microparticle immunoassay.Results The index of abnormal thrombin in liver cancer group was significantly higher than that of hepatitis group and liver hardener group.There was no significant difference in abnormal prothrombin concentration between liver hardener group and hepatitis group.The abnormal thrombin in liver cancer group,liver harden group and hepatitis group was significantly higher than the normal group.There was no significant difference in abnormal thrombin concentration between hepatocellular carcinoma group,hepatocellular carcinoma group and cholangiocarcinoma group.The index of serum abnormal thrombin was significantly higher than that of abnormal thrombin in liver cancer patients.Conclusion The serum abnormal thrombin index of hepatocellular carcinoma was significantly higher,and the abnormal thrombin concentration was significantly changed before and after the operation of hepatocellular carcinoma.The abnormal thrombin had certain value in the clinical diagnosis and the monitoring of the curative effect of hepatocellular carcinoma.