联合检测血清AFP，HCY和GGT对原发性肝细胞癌的诊断价值

Diagnostic Value of Combined Detection to Serum AFP, HCY and GGT for Primary Hepatocellnlar Carcinoma

目的探讨联合检测甲胎蛋白（AFP）、同型半眺氨酸（HcY）和r谷氨酰转移酶（GGT）在原发性肝细胞癌（HCC）中的诊断价值。方法共收集226例血清标本，其中原发性肝细胞癌（HCC）组患者血清99例，慢性肝病（慢肝）组70例，健康对照（对照）组57例；采用微粒子酶联免疫法、循环酶法和酶动力学法分别测定血清AFP，HCY和GGT浓度；SPSS统计学方法分析AFP，HCY和GGT及联合检测对HCC的诊断价值。结果HCC组血清AFP，HCY和GGT的浓度明显高于慢肝组和对照组，差异有统计学意义（P〈0．01）。血清AFP，HCY和GGT诊断HCC受试者工作特征曲线（ROC曲线）下面积（AUc）为AFP（0．823）〉HCY（0．803）〉GGT（0．775），诊断效能AFP〉HCY〉GGT。各指标单项检测时敏感度及准确度HCY〉GGT〉AFP，特异度AFP〉HcY〉GGT。AFP联合HcY与GGT，敏感度及特异度AFP＋HCY〉AFP＋GGT。三项指标联合检测敏感度明显升高（90．90％），但特异度下降明显（62．20％）。结论AFP，HCY和GGT两两联合和三项联合检测，优于AFP单项指标检测，可以显著提高HCC的阳性检出率。

Objective To explore diagnostic value of combined detection to serum AFP, HCY and GGT for primary hepatocel- lular carcinoma. Methods 226 cases of serum samples were collected,including 99 cases from primary hepatocellular carci noma （HCC）, 70 cases from chronic liver disease, and 57 cases from healthy control group. Microparticle enzyme immunoas- say, enzymatic cycling method, enzyme kinetics method were used to detect the concentration of AFP, HCY and GGT in ser urn. According to statistical analysis of combined detection,diagnostic value was analyzed. Results AFP, HCY and GGT de- tection in HCC group were significantly higher than that of chronic liver group and control group, and the differences were statistically significant （P〉 0.01）. The areas （AUC） under the receiver-operating characteristic curve （ROC curve） of AFP,HCY and GGT for HCC diagnosis were AFP （0. 823）〉HCY （0. 803）〉GGT （0. 775） ,and the diagnostic efficiency was AFP〉 HCY〉GGT. The single index detection sensitivity and accuracy was HCY〉GGT〉AFP,the specificity AFP〉 HCY〉GGT. The sensitivity and specificity of the combination with two indexes was AFP＋ HCY〉AFP＋ GGT. Three in- dex combination of sensitivity increased significantly （90.90%）, but the specificity declined significantly （62.20 %）. Conclu- sion The combinations of two or three indexes detection of AFP,HCY and GGT were better than that of single index de- tection and it could significantly improve HCC positive detection rates.