Logist判别分析6项检测对原发性肝癌诊断价值的探讨

Diagnostic Value of Legist Discreminant Analysis in Primary Hepatocellular Carcinoma

本文对55例原发性肝癌及51例肝硬化同时进行AFP、AFP变异体(AFP-V)、α_1-抗胰蛋白酶(AAT,生化法),γ-谷酰转肽酶(GGT)、GGT同工酶(GGT-Ⅱ,圆盘电泳法)、醛缩酶同工酶(ALD-A,放免法)测定,在苹果Ⅱ微机上计算出Logist判别函数方程,将各项数据代入后进行分析,得出各检测方法的敏感性、特异性、阳性预测值、阴性预测值及诊断总符合率。以诊断总符合率来看,Logist判别分析法最优,其他依序为AAT、GGT-Ⅱ、AFP、AFP-V、GGT、ALD-A。从对19例AFP阴性生肝癌的分析来看,以AAT、Logist判别分析及GGT的阳性率较高,从8例AFP阳性的肝硬化的分析来看,以GGT-Ⅱ、Logist差别分析、AFP-V及ALD-A有鉴别价值。

This study is carried out in order to assess the accuracy of Logist Discre-minant Analysis (LDA) for detection of primary hepatocellular carcinoma (PHC) from liver cirrhosis (LC). 55 patients of PHC and 51 of LC are tested with alpha-fetoprotein (AFP), AFP variant (AFP-V), al-antitrypsin (AAT), gamma-glutamyl transferase (GGT), GGT isoenzyme (GGT-II), aldolase isoenzyme (ALD-A) simultaneously. The parameter of each test is analysed with LDA performed by an Apple-II computer. The sensitivity, specificity, positive and negative predictive value of LDA are found to be the best than any other single test. The overall accuracy rate of LDA is 92.5% being superior to AAT (86.8%), GGT-II (79.2%), AFP (74.5%), AFP-V(73.4%), GGT (67.9%), and ALD-A (66.0%). In 19 cases of AFP negative PHC, the more effective tests are AAT, LDA and GGT. In 8 cases of AFP positive LC the GGT-II, LDA, AFP-V and ALD-A are more reliable. Basing on the results of this study the authors suggest that the LDA would be used in the differential analysis between PHC and LC since it is effective and reliable.