异常凝血酶原（DCP）对早期原发性肝癌的诊断价值

The early diagnostic value of des-carboxy prothrombin in primary hepatocellular carcinoma

目的探讨异常凝血酶原（DCP）在早期原发性肝癌（PHC）中的诊断价值。方法分别采用酶联免疫法（ELISA）和电化学发光法对50例PHC患者、35例肝硬化患者、35例体检健康者进行治疗前血清AFP和DCP测定，并比较各组水平差异，用受试者工作特征曲线（R（）C曲线）比较评价DCP在PHC早期诊断中的临床价值。结果PHC组、肝硬化组和对照组AFP值分别为（598.3±476.2）ng／mL、（19.2±9.8）ng／mL和（4.8±2.5）ng／mL；DCP的值分别为（710.5±409.8）mAU／mL、（34.9±8.9）mAU／mL和（7.9±3.1）ng／mL；PHC组的AFP和DCP均高于其他两组，差异有统计学意义（P〈0.05）。DCP和AFP检测PHC的灵敏度分别是72.1％和62.2％，差异无统计学意义（P〉0.05），而DCP的特异度为91.4％比AFP的特异度71.4％高，差异有统计学意义（X^2=4.629，P〈0.05）。ROC曲线显示，DCP检测PHC的曲线下面积（AUC=0.896）大于AFP（AUC=0.752），P=0.009。结论异常凝血酶原是诊断PHC的有效肿瘤标志物，值得在临床上应用和诊断。

Objective Explore diagnostic value of des-carboxy prothrombin in primary hepatocellular carcino- ma. Methods Alpha fetoprotein（AFP）and des-carboxy prothrombin（DCP）levels in serum were detected by enzyme- linked immunosorbent assay（ ELLSA） and electro-chemiluminescence. Among these samples 48 were with PHC, 35 were cirrhosis and 35 were healthy control group. The differences between the levels were compared and the value of DCP in diagnosis of PHC was assessed by ROC analysis. Results The value of DCP were（598.3±476.2）ng/mL, （19.2±9.8） ng/mL and（4.8±2.5）ng/mL in the group of PHC, cirrhosis and control group respectively, and the AFP value were（710.5±409.8） mAU/mL, （34.9±8.9） mAU/mL and（7.9±3.1） ng/mL respectively. Both AFP and DCP levels in the group of PHC were higher than the other two group, the difference between the two groups have statistical significance（P〈0.05）. The sensitivity of DCP and AFP was 72.1% and 91.4% respectively, the difference has no statistical significance（P〉0.05）,while the specificity of DCP and AFP was 62.2% and 71.4% re- spectively, the difference has statistical significance（X^2=4.629, P〈0.05）. ROC curves indicated a better accuracy for DCP（AUC 0. 896）than AFP（AUC 0.752）in diagnosis of PHC. Conclusion DCP is one of the good serologic in- dicator in diagnose PHC and it could use in the clinical diagnosis.