甲胎蛋白联合异常凝血酶原检测在肝癌早期诊断及疗效评估中的价值分析

Analysis of the value of AFP combined with abnormal prothrombin in the early diagnosis and curative effect evaluation of liver cancer

目的探讨甲胎蛋白(alpha-fetoprotei,AFP)和异常凝血酶原(abnormal prothrombin,APT)联合检测在肝癌早期诊断及疗效评估中的临床价值。方法选择肝细胞性肝癌(hepatocellular carcinoma,HCC)患者52例、肝硬化患者38例,同时随机抽取健康体检者30例为对照组。比较对照组、肝硬化组和HCC组AFP及APT的检测值;计算AFP、APT单独检测及联合检测HCC的特异度、灵敏度及准确度;分析HCC血清中AFP与APT的关系。结果HCC组AFP、APT检测值明显高于肝硬化组和对照组(P<0.05)。APT单独检测HCC的特异度明显高于AFP(P<0.05);AFP、APT联合检测HCC的灵敏度明显高于AFP、APT单独检测(P<0.05);AFP、APT联合检测HCC的特异度(2项同时超过临界值判定为阳性)明显高于AFP单独检测(P<0.05);AFP、APT联合检测HCC的准确度明显高于AFP单独检测(P<0.05)。Spearman相关分析显示AFP和APT均为独立升高,两者无相关性(P>0.05)。结论AFP、APT是临床诊断HCC的重要血清学指标,良好地区分了HCC和肝硬化,二者联合检测可显著提高检测的灵敏度,并一定程度上改善了检测准确度,2项同时超过临界值判定为阳性时特异度也保持在较高水平,对HCC具有重要诊断价值。

Objective To analyze the clinical value of combined detection of alpha-fetoprotein （AFP）and abnormal prothrombin （APT）in the early diagnosis and therapeutic evaluation of hepatocellular carcinoma.Methods Fifty-two patients with hepatocellular carcinoma（HCC）and 38 patients with cirrhosis were selected,and 30 healthy subjects were randomly selected as the control group.The detection values of AFPand APT were compared among 3 groups.The specificity,accuracy and sensitivity of AFPand APT single or combine detected for HCC were compared.The relationship between AFPand APT in serum of HCC was analyzed.Results The values of AFPand APT in HCC patients were significantly higher than those in liver cirrhosis group and normal group （P 0.05 ）.Conclusion APT and AFPwere important serological markers for clinical diagnosis of HCC,which could distinguish HCC and cirrhosis.Combined detection of AFPand APT could improve the diagnostic accuracy and sensitivity,and the diagnostic specificity remained at a high level.They have a profound diagnostic value for HCC.