三种常见血清肝酶在乙型肝炎相关性肝癌中表达的价值研究

Expression of three common serum enzymes in patients with hepatitis B related hepatocellular carcinoma

目的探讨丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及γ-谷氨酰胺转肽酶(GGT)联合诊断乙型肝炎(乙肝)相关性肝癌的价值,为临床相关诊断提供参考。方法选取华中科技大学同济黄州医院2015年11月至2017年11月收治的乙肝相关性肝癌患者118例为乙肝相关性肝癌组),另选取同期收治的肝硬化患者116例为肝硬化组,114例健康体检者作为对照组。对比三组受试者ALT、AST及GGT含量及各指标特异度、灵敏性,并进行ROC曲线分析。结果乙肝相关性肝癌组血清ALT、AST及GGT含量均高于肝硬化组及对照组,且肝硬化组上述血清指标含量均高于对照组[(267.1±131.5)U/L比(31.2±11.3)U/L比(17.4±4.6)U/L,(76.6±23.2)U/L比(45.2±13.1)U/L比(24.3±6.6)U/L,(125.3±42.6)U/L比(53.1±17.6)U/L比(22.4±4.4)U/L],差异均有统计学意义(均P<0.05);ROC曲线图显示:GGT曲线下面积0.85,ALT曲线下面积0.78,AST曲线下面积0.73,三项指标者联合诊断曲线下面积0.95。三项联合诊断的灵敏度及特异度高于ALT、AST及GGT单项诊断。结论乙肝相关性肝癌患者血清ALT、AST及GGT含量升高,且三项指标联合诊断具有较高的灵敏度和特异度,值得临床借鉴。

Objective To explore the clinical value of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and gamma-glutamine transpeptidase(GGT) in the diagnosis of hepatitis B-related hepatocellular carcinoma, and to provide reference for clinical diagnosis. Methods From November 2015 to November 2017, 118 patients with hepatitis B-related primary liver cancer (hepatitis B-related primary liver cancer group) admitted to Tongji Huangzhou Hospital of Huazhong University of Science and Technology were selected.And 116 patients with cirrhosis (hepatocirrhosis group) and 114 healthy people were selected as control group.The levels of ALT, AST and GGT and the specificity and sensitivity of each index were compared among the three groups, and the ROC curve was analyzed. Results The levels of serum ALT, AST and GGT in the hepatitis B-related primary hepatocellular carcinoma group were higher than those in the cirrhosis group and the control group, and the above serum indicators in the cirrhosis group were higher than those in the control group[(267.1±131.5)U/L vs.(31.2±11.3)U/L vs.(17.4±4.6)U/L,(76.6±23.2)U/L vs.(45.2±13.1)U/L vs.(24.3±6.6)U/L,(125.3±42.6)U/L vs.(53.1±17.6)U/L vs.(22.4±4.4)U/L, all P<0.05]. ROC curve showed that the area under GGT curve was 0.85, under ALT curve was 0.78, and under AST curve was 0.73, the area under the combined diagnostic curve of the three indicators was 0.95.The sensitivity and specificity of three combined diagnosis were higher than those of ALT, AST and GGT. Conclusion The levels of serum ALT, AST and GGT in patients with hepatitis B-related primary liver cancer are elevated, and the combined diagnosis of the three indicators has high sensitivity and specificity, which is worthy of clinical reference.