期刊文献+

血清AFP、AFP-L3和PIVKA-Ⅱ在诊断肝癌中的临床应用评估 被引量:14

The diagnostic value of serum AFP、AFP-L3 and PIVKA-II in hepatocellular carcinoma
原文传递
导出
摘要 目的 探讨甲胎蛋白(alpha-fetoprotein,AFP)、甲胎蛋白异质体(alpha-fetoprotein-L3,AFP-L3)和异常凝血酶原(prothrombin induced by vitamin K absence-Ⅱ,PIVKA-Ⅱ)在肝癌诊断中的临床应用价值。方法收集2013年在我院确诊的乙型肝炎、肝硬化和肝癌的住院患者血清235例。其中良性肝病组包括乙型肝炎及肝硬化共计150例,肝细胞癌组85例。应用微量离心柱法分离血清AFP-L3,应用电化学发光免疫分析仪检测AFP及AFP-L3含量,应用酶免疫发光分析仪检测PIVKA-Ⅱ含量。结果良性肝病组的AFP及PIVKA-Ⅱ水平均低于肝细胞癌组,其中AFP、PIVKA-Ⅱ在肝细胞癌组与良性肝病组之间均差异存在统计学意义(P<0.001)。ROC分析显示,AFP、PIVKA-Ⅱ及AFP-L3的AUC分别为0.712、0.755和0.513。当AFP临界值为20ng/ml时,灵敏度为61.2%,特异性为74%;当PIVKA-Ⅱ临界值为62.5AU/ml时,灵敏度为58.8%,特异性为82.6%;当AFP-L3比值临界值为10%时,灵敏度为47.7%,特异性为66.7%。血清PIVKA-Ⅱ和AFP浓度与肿瘤体积的秩相关系数分别为0.395和0.244(P值分别为<0.001和0.03)。结论PIVKA-Ⅱ较AFP及AFP-L3能提供更好的诊断效能,PIVKA-Ⅱ应用于肝细胞癌诊断可提供更高的实验诊断特异度,同时能提供与疾病相关的更有价值的信息用于临床评估。 Objective To explore the clinical application value of AFP, AFP-L3 and PIVKA-Ⅱ in diagnosis of hepatocellular carcinoma (HCC). Methods A total of 235 in-patients with hepatitis B, cirrhosis or hepatocellular carcinoma diagnosed in our hospital in 2013 were enrolled in this study. Among them, the benign liver disease (BLD) group included 150 cases of hepatitis B and cirrhosis, and HCC group included 85 cases. Serum AFP-L3 level was measured by micro-centrifugal column method. The AFP and AFP-L3 levels were analyzed by Roche E170 immunoassay system and PIVKA-Ⅱ level was analyzed by Fujirebio-Lumipulse G1200 system. Results BLD group have lower AFP and PIVKA-Ⅱ levels compare with HCC group. Significant differences of AFP and PIVKA-Ⅱ levels between BLD and HCC group were found. ROC analysis shows that the areas under curve (AUC) of AFP, PIVKA-II and AFP-L3 were 0.712, 0.755 and 0.513, respectively. AFP with a cut-off value of 20 ng/ml shows sensitivity of 61.2% and specificity of 74.0%, and PIVKA-Ⅱ with a cut-off value of 62.5 mAU/ml has sensitivity of 58.8% and specificity of 82.6%, but when the AFP-L3 ratio cutoff value is 10%, the sensitivity is just 47.7% and the specificity is 66.7%. Moreover, the Spearman′s correlation of PIVKA-Ⅱ or AFP with tumor size is 0.395 and 0.244, respectively(P<0.001 and P=0.03). Conclusions PIVKA-Ⅱ provides better diagnostic performance than AFP and AFP-L3. Using PIVKA-Ⅱ for the diagnosis of Hepatocellular carcinoma provides higher sensitivity and more valuable disease-related information for clinical evaluation.
作者 安云飞 蔡蓓 苏真珍 李立新 An Yunfei;Cai Bei;Su Zhenzhen;Li Lixin(Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China)
出处 《中华临床实验室管理电子杂志》 2019年第2期75-79,共5页 Chinese Journal of Clinical Laboratory Management(Electronic Edition)
关键词 肝细胞癌 甲胎蛋白 甲胎蛋白异质体 异常凝血酶原 Hepatocellular carcinoma Alpha-fetoprotein Alpha-fetoprotein-L3 Prothrombin induced by vitamin K absence-Ⅱ
  • 相关文献

参考文献2

二级参考文献14

  • 1Adbel-Rahman El-Zayadi,Hanaa M Badran,Eman MF Barakat,Mohy El-Deen Attia,Sherine Shawky,Mostafa K Mohamed,Osaima Selim,Ahmed Saeid.Hepatocellular carcinoma in Egypt: A single center study over a decade[J].World Journal of Gastroenterology,2005,11(33):5193-5198. 被引量:5
  • 2Chaur-Shine Wang,Chin-Lin Lin,Hsi-Chang Lee,Kuan-Yang Chen,Ming-Feng Chiang,Hung-Sheng Chen,Tsung-Jung Lin.Usefulness of serum des-γ-carboxy prothrombin in detection of hepatocellular carcinoma[J].World Journal of Gastroenterology,2005,11(39):6115-6119. 被引量:19
  • 3Yasushi Tamura,Masato Igarashi,Hirokazu Kawai,Takeshi Suda,Shinji Satomura,Yutaka Aoyagi.Clinical Advantage of Highly Sensitive On-Chip Immunoassay for Fucosylated Fraction of Alpha-Fetoprotein in Patients with Hepatocellular Carcinoma[J].Digestive Diseases and Sciences.2010(12)
  • 4Satoru Hagiwara,Masatoshi Kudo,Toshihiko Kawasaki,Miki Nagashima,Yasunori Minami,Hobyung Chung,Toyokazu Fukunaga,Masayuki Kitano,Tatsuya Nakatani.Prognostic factors for portal venous invasion in patients with hepatocellular carcinoma[J].Journal of Gastroenterology.2006(12)
  • 5Bae JS,Park SJ,Park KB, et a1.Acute exacerbation of hepatitis in liver cirrhosis with very high levels of alpha-fetoprotein but no occurrence of hepatocellular carcinoma[].Korean Journal of Internal Medicine.2005
  • 6Yamashita F,Tanaka M,Satomura S,et al.Prognostic significance of Lens culinaris agglutinin A-reactive alpha-fetoprotein in small hepatocellular carcinomas[].Gastroenterology.1996
  • 7Shiraki K,Takase K,Tameda Y,et al.A clinical study of lectin-reactive alpha-fetoprotein as an early indicator of hepatocellular carcinoma in the follow-up of cirrhotic patients[].Hepatology.1995
  • 8Khien V V,Mao H V,Chinh T T,et al.Clinical evaluation of lentil lectin-reactive alpha-fetoprotein-L3 in histology-proven hepatocellular carcinoma[].International Journal of Biological Markers.2001
  • 9Oka H,Saito A,Ito K,et al.Multicenter prospective analysis of newly diagnosed hepatocellular carcinoma with respect to the percentage of Lens culinaris agglutinin-reactive alpha-fetoprotein[].Journal of Gastroenterology.2001
  • 10Okuda H,Obata H,Nakanishi T,et al.Production of abnormal prothrombin(des-gamma-carboxy prothrombin) by hepatocellular carcinoma, a clinical and experimental study[].Journal of Hepatology.1987

共引文献140

同被引文献138

引证文献14

二级引证文献60

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部