早期肝细胞癌临床诊断中脱-γ-羧基凝血酶原检测的应用价值分析

Early clinical diagnosis value of hepatocellular carcinoma of des-γ-carboxy prothrombin test

目的讨论肝细胞癌(hepatocellular carcinoma,HCC)的临床早期诊断中脱-γ-羧基凝血酶原(des-γ-carboxy prothrombin,DCP)检测的应用价值。方法选取2014年1月—2015年3月收治的HCC患者42例作为HCC组;选择同期住院的其他肿瘤患者38例作为其他肿瘤组;选择同期住院的肝脏疾病(非HCC)患者40例作为肝病组;另选健康体检者36例作为对照组。测定并比较各组DCP及AFP含量。计量资料比较采用方差分析,两两比较采用LSD-t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 HCC组、其他肿瘤组、肝病组、对照组AFP及DCP浓度分别为(793.12±682.28)、(653.28±457.26)、(9.68±8.24)、(11.14±6.58)、(8.82±7.82)、(9.12±5.83)、(4.15±3.01)、(3.82±2.03)ng/ml,HCC组显著高于其他三组,差异均有统计学意义(均P<0.05)。其他肿瘤组及肝病组显著高于对照组,差异均有统计学意义(均P<0.05)。HCC定界值为AFP>20ng/ml时,特异性、灵敏度分别为71.43%、83.26%;HCC定界值为DCP>12 ng/ml时,灵敏度、特异性分别为81.18%、73.82%,二者联合时分别为87.68%、81.01%;均高于二者单独使用。HCC病灶大小与DCP浓度存在正相关关联(r=0.664)。结论 DCP可有效对HCC进行诊断,联合AFP效果更佳。

Objective Discuss early diagnosis of hepatocellular carcinoma（ HCC） in des- γ- value carboxy prothrombin（ DCP） detection. Methods 42 cases of HCC from January 2014 to March 2015 were selected as HCC group; 38 cases of others hospitalized cancer patients at the same period as other tumor group; 40 cases of patients with liver disease as liver diseases group; 36 cases of healthy people as control group. Determine and compare the content of DCP and AFP of each group. Measurement data were compared by AVONA,pairwise comparisons using LSD- t test,count data using chi square test,P〈 0. 05 was considered statistically significant. Results AFP and DCP level of HCC group,other tumor group,liver disease group,control group were（ 793. 12 ± 682. 28）,（ 653. 28 ± 457. 26）,（ 9. 68 ± 8. 24）,（ 11. 14 ± 6. 58）,（ 8. 82 ±7. 82）,（ 9. 12 ± 5. 83）,（ 4. 15 ± 3. 01）,（ 3. 82 ± 2. 03） ng / ml,HCC group was significantly higher than other three groups,the differences were statistically significant（ all P〈 0. 05）. The AFP and DCP level of other tumor group and liver disease group were significantly higher than the control group,the differences were statistically significant（ all P〈 0. 05）.When HCC delimitation value set to AFP 20 ng / ml,the sensitivity,specificity were 71. 43%,83. 26%; when HCC delimitation value set to DCP 12 ng / ml,the sensitivity and specificity were 81. 18%,73. 82%,when combined,the sensitivity and specificity were 87. 68%,81. 01%; both were higher than those used alone. HCC lesion size and DCP concentration was positively correlated（ r = 0. 664）. Conclusions DCP has effectively effect in the diagnosis of HCC,combined with AFP was better.