异常糖链糖蛋白与甲胎蛋白在肝癌诊断及预后评估中的应用价值

The value of tumor abnormal protein and alpha fetoprotein in the diagnosis and prognosis of liver cancer

目的探讨肿瘤异常糖链糖蛋白(tumor abnormal protein,TAP)在肝癌诊断及预后评估中的应用价值。方法选取原发性肝癌患者79例(肝癌组),肝硬化患者77例(肝硬化组),两组患者均有基线TAP和甲胎蛋白(alpha fetoprotein,AFP)检测值,比较各组TAP及AFP灵敏度、特异度、阴性预测值、阳性预测值,并计算其AUC值,并对肝癌组患者手术治疗前后的TAP水平变化和肝癌患者无复发生存率的相关性进行初步研究。结果相较于肝硬化组,肝癌组患者的TAP水平明显更高,差异有统计学意义(P<0.05);分别计算TAP及AFP单独检测及AFP或TAP,AFP和TAP的灵敏度、特异度、阴性预测值、阳性预测值及其AUC值,AFP、TAP联合检测其特异度及AUC(0.765)最高,差异有统计学意义(P<0.05);相较于手术治疗前,肝癌患者术后1个月的AFP及TAP水平明显更低,患者术后1周TAP变化水平较AFP变化水平更具有诊断价值,依靠术后1个月的TAP水平作为评估指标,相较于疾病稳定和疾病进展的肝癌患者,部分缓解患者的无复发生存率明显更高,差异有统计学意义(P<0.05)。结论肝癌诊断和预后评估中TAP的应用效果较好,干扰因素少,潜在应用价值较高。

Objective To investigate the value of tumor abnormal protein(TAP)and alpha fetoprotein(AFP)in the diagnosis and prognosis of liver cancer.Methods 79 cases of primary liver cancer patients(liver cancer group)and 77 patients with liver cirrhosis(liver cirrhosis group)were collected,two groups of patients had a baseline TAP and AFP(AFP)readings,TAP and AFP sensitivity,specific,negative predictive value,positive predictive value were compared between two groups,and then the AUC value was calculated.Before and after surgical treatment,the TAP level change and the correlation of relapse-free survival rate of liver cancer were in preliminary research.Results Compared with liver cirrhosis group,TAP level of patients in liver cancer group was significantly higher,and the difference was statistically significant(P<0.05).The sensitivity,specificity,negative predictive value,positive predictive value and their AUC values of TAP and AFP were calculated separately for TAP and AFP or TAP,AFP and TAP,respectively.The highest specificity and AUC value(0.765)were detected by the combination of TAP and AFP,and the difference was statistically significant(P<0.05).Compared with preoperative treatment,the postoperative TAP level of patients in liver cancer group was significantly lower,and 1 month postoperative TAP level was used as the evaluation index.Compared with liver cancer patients with stable disease and disease progression,the relapse-free survival rate of patients with partial remission was significantly higher,and the difference was statistically significant(P<0.05).Conclusion TAP has good effect and potential value in diagnosis and prognosis of liver cancer.