甲胎蛋白、甲胎蛋白异质体与TNF-α因子联合检测在原发性肝癌诊断中的应用价值

Application of combined detection of alpha-fetoprotein,alpha-fetoprotein heterogeneity and TNF-α factor in the diagnosis of primary liver cancer and its clinical value

目的探讨甲胎蛋白、甲胎蛋白异质体与肿瘤坏死因子α(TNF-α)联合检测在原发性肝癌诊断中的应用效果及价值。方法回顾性选取2017年1月至2018年5月原发性肝癌患者40例作为对象,设为观察组;选择同期健康体检者40例,设为对照组。采用罗氏E601电化学发光分析系统测定两组甲胎蛋白、甲胎蛋白异质体水平;采用酶联免疫吸附试验测定两组TNF-α水平;分析不同临床病理特征(肿瘤大小、肿瘤分期、肿瘤分化程度等)下甲胎蛋白、甲胎蛋白异质体与TNF-α水平;绘制ROC曲线,分析甲胎蛋白、甲胎蛋白异质体与TNF-α水平在原发性肝癌患者中的诊断效能。结果观察组原发性肝癌患者甲胎蛋白、甲胎蛋白异质体与TNF-α因子水平高于对照组(P <0. 05);原发性肝癌患者肿瘤大小≥3 cm、低分化、肿瘤分期Ⅲ~Ⅳ期者血清甲胎蛋白、甲胎蛋白异质体与TNF-α水平明显高于肿瘤大小<3 cm、中高分化、肿瘤分期Ⅰ~Ⅱ期者,差异均有统计学意义(P <0. 05)。ROC曲线分析结果表明:甲胎蛋白、甲胎蛋白异质体与TNF-α联合测定诊断敏感度、特异度,高于单一甲胎蛋白、甲胎蛋白异质体与TNF-α(P <0. 05)。结论甲胎蛋白、甲胎蛋白异质体与TNF-α水平在原发性肝癌患者中呈高表达,且与临床病理存在紧密联系,能反映患者疾病严重程度,且三者联合测定用于原发性肝癌患者能获得较高诊断敏感度、特异度。

Objective To explore the effect and value of combined detection of alpha-fetoprotein,alpha-fetoprotein heterogene and tumor necrosis factor α( TNF-α) in the diagnosis of primary liver cancer. Methods Forty patients with primary liver cancer from January 2017 to May 2018 were retrospectively selected as the observation group. 40 healthy subjects during the same period were selected as the control group.The levels of alpha-fetoprotein and alpha-fetoprotein heterogeneity were determined by Roche E601 electrochemiluminescence analysis system.The levels of TNF-α were determined by enzyme-linked immunosorbent assay( ELISA). The levels of alpha-fetoprotein,alpha-fetoprotein heterogene and TNF-α were analyzed under different pathological data,such as tumor size,tumor stage,degree of tumor differentiation;ROC curve was drawn to analyze the diagnostic efficacy of alpha-fetoprotein,alpha-fetoprotein heterogene and TNF-α levels in primary liver cancer.Results The levels of alpha-fetoprotein,alpha-fetoprotein heterogene and TNF-α were higher in the observation group than those in the control group( P < 0. 05). The levels of alpha-fetoprotein,alpha-fetoprotein heterogeneity and TNF-α in patients with tumor size ≥3 cm,poorly differentiated,and tumor stage III to IV were significantly higher than those with tumor size < 3 cm,moderately differentiated,tumor Stages Ⅰto Ⅱ,and the differences were statistically significant( P < 0. 05). The results of ROC curve analysis showed that the combination of alpha-fetoprotein,alpha-fetoprotein heterogene and TNF-α was sensitive and specific,and were more sensitive and specific than single alpha-fetoprotein,alpha-fetoprotein heterogene and TNF-α( P < 0. 05). Conclusion Alpha-fetoprotein,alpha-fetoprotein heterosomes and TNF-αare highly expressed in patients with primary liver cancer,and are closely related to the clinicopathology,which can reflect the severity of the patient’s disease. The combination of the three has good diagnostic sensitivity and specificity in primary liver cancer.