应用ROC曲线评价5'-NT和甲胎蛋白联合检测在早期原发性肝细胞癌诊断中的价值

Early diagnostic combined detection of serum AFP and 5'-NT in hepatocellular carcinoma by ROC

目的:应用ROC曲线评价血清5'-核苷酸酶(5'-NT)和甲胎蛋白(AFP)联合检测在原发性肝细胞癌(hepatocellular carcinoma,HCC)诊断中的应用,以寻找一组诊断HCC更敏感的指标,为早期诊断及治疗提供依据。方法:分别采用过氧化物酶法及电化学发光免疫分析法测定132例肝细胞癌患者(肝细胞癌组)、85例肝硬化患者(肝硬化组)、138例肝炎患者(肝炎组)和100例健康体检者(对照组)的血清5'-NT和AFP的浓度,并使用统计学软件对结果进行处理及分析。结果:血清5'-NT和AFP的水平在HCC组、肝硬化组、肝炎组和对照组间存在显著性差别,差异具有统计学意义(P<0.05);二者联合检测HCC的敏感度为93.94%,较单项检测高(P<0.05),特异度为84.10%;二者联合诊断HCC的曲线下面积为0.948,较单项高,差异亦具有统计学意义(P<0.05)。结论:血清5'-NT和AFP联合检测可提高HCC诊断的敏感度和准确度,对HCC的早期诊断具有十分重要的临床价值。

Objective： To investigate the diagnostic value of combined detection of serum 5＇-NT and AFP in hepatocellular carcinoma（ HCC） by ROC. Methods： The level of serum 5 ＇-NT and AFP in hepatocellular carcinoma group（ 132 cases）,hepatic cirrhosis group（ 85 cases） 、hepatitis group（ 138 cases） and control group（ 100 cases） were detected by peroxidase method and electrochemiluminescence immunoassay（ ECLI）. Results： The levels of serum 5＇-NT and AFP were significantly different between HCC group,hepatic cirrhosis group、hepatitis group and control group,difference was statistically significant（ P〈0. 05）. The sensitivity of two indicators for diagnosing HCC was 93.94%,which was higher than single detection（ P〈0. 05）,the specificity was 84. 10%,the area under ROC curves of combined detection of two indicators was 0. 948,which was also higher than single detection（ P〈0. 05）. Conclusion：The combined detection of serum 5 ＇-NT and AFP can greatly increase the sensitivity and accuracy for diagnosing HCC,which has an important clinical value for early diagnosis.