血清AFP、AFU、GP73及SF联合检测在原发性肝癌早期诊断中应用价值分析

Diagnostic Value of Serum AFP,AFU,GP73 and SF in Patients with Primary Hepatocellular Carcinoma

目的探讨血清甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)、高尔基体蛋白73(GP73)及铁蛋白(SF)四者联合检测在原发性肝癌(PHC)早期诊断中的应用价值。方法选取2014年10月至2015年10月华北理工大学附属医院收治的60例PHC患者作为观察组,并选取同一时期我院收治的40例肝炎肝硬化患者作为疾病对照组,及40例健康志愿者作为健康对照组,采用酶联免疫法(ELISA)分别检测三组入选者血清AFP、AFU、GP73及SF水平。结果观察组患者血清AFP、AFU、GP73及SF水平均显著高于疾病对照组与健康对照组,差异有统计学意义(P<0.05);观察组患者AFP、AFU、GP73、SF及四者联合检测的阳性率均显著高于疾病对照组与健康对照组的检测阳性率,差异有统计学意义(P<0.05);在PHC的诊断中,AFP、AFU、GP73及SF四者联合检测的灵敏度为95.0%,显著高于四者单独检测的灵敏度65.0%、73.3%、78.3%、61.7%,同时上述四指标联合检测的特异度为67.5%,显著低于四者单独检测的灵敏度76.3%、77.5%、78.8%、83.8%,差异均有统计学意义(P<0.05);而四指标联合检测的准确度略高于单独检测,差异无统计学意义(P>0.05)。结论血清AFP、AFU、GP73及SF检测对原发性肝癌的诊断均具有较好的临床价值,而AFP、AFU、GP73及SF四者联合检测能够显著提高检测的灵敏度,对PHC的早期诊断具有重要的临床意义。

Objective To explore the diagnostic value of serum AFP, AFU, GP73 and SF in patients with primary hepatocellular carcinoma （PHC）. Methods A total of 60 cases of PHC who were treated in Affiliated Hospital of North China University during October 2014 to October 2015 were selected as observation group, 40 cases of liver cirrhosis who were treated in the same period was selected asdisease control group, and 40 normal volunteers were selected ashealthy control group. ELISA method was used to detect serum AFP, AFU, GP73 and SF. Results Serum AFP, AFU, GP73 and SF in observation group were significantly higher than that of disease control group and healthy control group （P 〈 0.05）. The positive rate of individual AFP, AFU, GP73, SF and 4-panel test were significantly higherin observation group than that of disease control group and health control group （P 〈 0.05 ）. In terms of diagnosis of PHC, the sensitivity of 4- panel ofAFP, AFU, GP73 and SF was 95.0%, which was significantly higher than that of individural detection （65.0%, 73.3%, 78.3%, 61.7%, respectively, P 〈0.05）. And the specificity of 4-panel test was 67.5%, which was significantly lower than that of individual detection（76.3%, 77.5%, 78.8%, 83.8%, respectively, P 〈0.05）. But the accuracy of 4- panel test just slightly higher than that of individural detection （ P 〉 0.05 ）. Conclusion Serum FP, AFU, GP73 and SF are valuable in diagnosis of PHC. 4- panel test of serum FP, AFU, GP73 and SF can significantly increase the sensitivity of detection, whichis worthy of further clinical application.