PIVKA-Ⅱ在乙型肝炎病毒感染者中筛查HCC的应用价值分析

Application Value PIVKA-Ⅱ Screens HCC in Patients with Hepatitis B Virus Infection

目的:探讨血清样本中拮抗剂Ⅱ诱导的蛋白异常凝血酶原(PIVKA-Ⅱ)在乙型肝炎病毒感染者中筛查肝细胞癌(hepatocellular carcinoma,HCC)的应用价值。方法:选取本院2015年11月-2017年6月收治的193例肝癌患者(肝癌组)及141例良性肝病患者(良性肝病组)的血清样本,比较两组PIVKA-Ⅱ、HBV的阳性率,分析两项指标在肝癌与良性肝病中的分布。结果:肝癌组PIVKA-Ⅱ、HBV的阳性符合率为77.20%,差异无统计学意义(P>0.05)。良性肝病组PIVKA-Ⅱ、HBV的阳性符合率为36.17%,差异有统计学意义(P<0.01)。肝癌组PIVKA-Ⅱ浓度水平较良性肝病组明显升高,差异有统计学意义(P<0.01)。结论:乙肝病毒的持续感染诱发干细胞癌变,而PIVKA-Ⅱ由HCC细胞分泌是HCC检测的特异性指标,因此PIVKA-Ⅱ可作为在乙型肝炎病毒感染者中筛查HCC是较理想的辅助指标。

Objective：To investigate the application value of PIVKA-Ⅱ in serum samples screening hepatocellular carcinoma（HCC） in patients with hepatitis B virus（HBV） infection.Method：A total of 193 patients with HCC（HCC group） and 141 patients with benign liver disease（benign liver disease group） in our hospital from November 2015 to June 2017 were selected as serum samples.The positive rates of PIVKA-Ⅱ and HBV were compared between two groups,and the distribution of the positive rates of PIVKA-Ⅱ and HBV was analyzed in HCC and benign liver disease.Result：The positive coincidence rate of PIVKA-Ⅱ and HBV in HCC group was 77.20%（P〈0.05）.The positive coincidence rate of PIVKA-Ⅱ and HBV in benign liver disease group was 36.17%（P〈0.01）.The concentration of PIVKA-Ⅱ in HCC group was significantly higher than that in benign liver disease group,the difference was statistically significant（P〈0.01）.Conclusion：The persistent infection of HBV induced the hepatocellular carcinogenesis.PIVKA-Ⅱ secreted by HCC cells is a specific test indicator of HCC.Therefore,PIVKA-Ⅱ could be used as an ideal auxiliary indicator for screening HCC in patients with HBV infection.