血清前白蛋白检测在诊断肝硬化并发肝癌中的应用

STUDY OF APPLICATIONAL VALUE OF SERUM PREALBUMIN IN PATIENTS MTH HEPATOCIRRHOSIS COMPLICATED BY HEPATOMA

检测了１０８例正常成人参考样本、３７例经手术和病理活检确诊的肝硬化并发肝癌患者、１２例与肝损害关系不大的良性疾病患者血清ＰＡ含量。实验表明：ＰＡ对肝硬化并发肝癌诊断的阳性预告值（＋ＰＶ）为１００％，阴性预告值（－ＰＶ）８０．０％，诊断敏感度（Ｓｅ）９１．８９％，特异性（Ｓｐ）１００％，准确度（Ａｃ）９３．８８％ＰＡ对该病的诊断敏感度明显优于ＡＬｂ、γ－ＣＴ、ＩＣＧＲ１５、ＡＬＴ、ＡＬＰ等几项目前常用生化指标；并指出ＰＡ明显减低对ＡＦＰ阴性而ＨＢｓＡｇ阳性的肝硬化并发肝癌的诊断可能具有特殊意义。

The levels of Serum prealbumin(PA)in 108 cases of norma1 adultand 37 cases of patient with hepatocirrhosis complicated by hepatoma confirmed by thesurgical operation and histopathology and 12 casews of patient without liver disease weremeasured The result of experiment showeds that the positive predictive value( + PV)and the negative predictive value(-PV)of the dstermination of serum PA for the dia-gnosis of hepatocirrhosis complicated by hepatoma were l00%and 80%,the sensitivityrate(Se) was 91.89%,the specificity rate(SP)was 100%and the accuracy rate(Ac) was93.88%,which were better than the diagnostic value of determination of albumin(ALB),γ-glutamyl transpeptidase(γ-GT),fifteen minutes retention rate of indocyine(ICGR)15’),alanine anunotransferase(ALT) or alkaline phosphatase (PLP) in human serum.Itwas considered also that an obvious lower value of PA in human serum might possesssome specific significance for the thagnosis of hepatocirrhosis complicatd by hepatomawhich had a negative alpha fetoprotein(α-FP)and positive hepatitis B surface antigen(HBsAg).