AFP、AFU、TSGF联合检测在早期肝癌中的诊断效能

Diagnostic performance of combined detection of AFP, AFU and TSGF in early liver cancer

目的探讨血清甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)、肿瘤特异性生长因子(TSGF)联合检测诊断早期肝癌的效能。方法选取80例早期原发性肝癌患者(早期肝癌组)和78例肝硬化患者(慢性肝病组)的临床资料以及同期76例健康体检者(对照组)的体检结果。比较3组患者血清AFP、AFU、TSGF的表达水平及阳性表达率,分析早期肝癌组AFP阴性患者血清AFU、TSGF阳性表达率,及AFP、AFU、TSGF单项检测及联合检测诊断早期肝癌的灵敏度、特异度、准确度和约登指数。结果早期肝癌组患者血清AFP、AFU、TSGF表达水平及阳性表达率均高于慢性肝病组和对照组,差异均有统计学意义(P﹤0.05);慢性肝病组患者血清AFP、AFU、TSGF表达水平及阳性表达率均高于对照组,差异均有统计学意义(P﹤0.05)。早期肝癌组患者中AFP阴性29例,其中TSGF、AFU、AFU+TSGF检测的阳性表达率分别为68.97%、82.76%、86.21%。在单项诊断和联合诊断中,AFP+AFU+TSGF诊断早期肝癌的灵敏度、准确度、约登指数均最高,分别为95.00%、89.76%、0.81;AFU诊断早期肝癌的特异度最高,为94.16%。结论与单项诊断和两项联合诊断比较,AFP+AFU+TSGF联合检测可提高早期肝癌诊断的灵敏度和准确度,具有更高的诊断价值,对早期肝癌诊断有重要的意义。

Objective To investigate the diagnostic performance of combined detection of serum alpha fetoprotein(AFP),α-L-fucosidase(AFU)and tumor specific growth factor(TSGF)in early liver cancer.Method The clinical data of 80 patients with early primary liver cancer(early liver cancer group),78 patients with liver cirrhosis(chronic liver disease group)and physical examination results of 76 health subjects(control group)were collected.The levels and positive expression rates of AFP,AFU and TSGF in the three groups were compared.The positive expression rates of AFU and TSGF in the AFP-negative patients in the early liver cancer group were analyzed.The sensitivity,specificity,accuracy and Yoden index of single and combined detection in diagnosis of early liver cancer were analyzed.Result The levels of serum AFP,AFU and TSGF and the positive expression rates in the early liver cancer group were significantly higher than those in the chronic liver disease group and the control group(P<0.05),and chronic liver disease group significantly higher than those in the control group(P<0.05).In 29 patients with AFP-negative liver cancer,the positive rates of TSGF,AFU and AFU+TSGF were 68.97%,82.76%and 86.21%,respectively.In single and combined detection,the sensitivity,accuracy and Yoden index of AFP+AFU+TSGF were highest,which were 95.00%,89.76%and 0.81,respectively.The highest specificity of single AFU detection was 94.16%.Conclusion AFP+AFU+TSGF combined detection can improve the sensitivity and accuracy of diagnosis in early liver cancer compared with single and pairwise combined detections,and has higher diagnostic value,which is of great significance for the diagnosis of early liver cancer.