肿瘤标志物与新型寡糖链检测在原发性肝癌诊断中的应用研究

The Application of Tumor Markers and Novel Oligosaccharide Chain Detection in the Diagnosis of Primary Liver Cancer

目的探究肿瘤标志物甲胎蛋白(alpha fetal protein,AFP)、异常凝血酶原(PIVKA-Ⅱ)和寡糖链组分的相对含量(G-test)分别在原发性肝癌检测中的临床应用价值。方法选取2017年10月至2017年12月首都医科大学附属北京佑安医院临床诊断原发性肝癌(hepatoma carcinoma cell,HCC)组共165例,非肝癌组共142例,分别用仪器检测两组患者AFP、PIVKA-Ⅱ及G-test,通过统计学方法来对肿瘤标志物AFP、PIVKA-Ⅱ和G-test诊断的灵敏度、特异性和准确度进行分析。结果在灵敏度上,G-tes的灵敏度最高(83.6%),AFP的灵敏度最低(16.4%),且差异有统计学意义;在特异性上,AFP的特异性最高(97.9%),G-test的特异性最低(73.2%),且差异有统计学意义;在准确度上,G-test的准确度最高(78.8%),AFP的准确度最低(54.1%),且差异有统计学意义。联合检测时G-test+PIVKA-Ⅱ的ROC曲线下面积(area under the curve,AUC)与G-tesT+AFP的AUC一样(86.3%),高于AFP+PIVKA-Ⅱ的AUC(68.3%),G-test+AFP+PIVKA-Ⅱ的AUC为86.4%,灵敏度为93.3%。结论G-test诊断原发性肝癌的价值较AFP、PIVKA-Ⅱ高,AFP诊断灵敏度最高,联合检测时可提高检测率,G-test值较传统的原发性肝癌肿瘤标志物对原发性肝癌的检出率更高,意义更大。

Objective To investigate the clinical application of tumor markers,including alpha fetal protein(AFP)and abnormal prothrombin(PIVKA-Ⅱ),and the relative content of oligosaccharide chain components(G-test value)in the detection of primary liver cancer value.Methods From October,2017 to December,2017,a total of 165 patients with primary liver cancer(hepatoma carcinoma cell(HCC))through the clinical diagnosis and 142 patients with non-hepatic cancer were selected for the study.The relative contents(G-test value)of AFP,PIVKA-Ⅱand oligosaccharide chain components in both groups were measured.The sensitivity,specificity and accuracy of the tumor markers,including AFP and PIVKA-Ⅱ,and G-test values were statistically analyzed.Perform analysis was also conducted.Results The relative content of oligosaccharide chain components(G-test)had the highest sensitivity(83.6%),while the sensitivity of alpha-fetoprotein was the lowest(16.4%),and the difference was statistically significant.The specificity of fetal protein was the highest(97.9%),while the specificity of G-test was the lowest(73.2%),and the difference was statistically significant.The accuracy of G-test was the highest(78.8%),while the accuracy of AFP was the lowest(54.1%),and the difference was statistically significant.The area under the curve(AUC)of G-test+PIVKA-Ⅱas the joint detection was the same as the area under the curve(AUC)for G-tesT+AFP(86.3%),and higher than the area under the curve(AUC)for AFP+PIVKA-Ⅱ(68.3%).The AUC of G-test+AFP+PIVKA-Ⅱwas 86.4%,and the sensitivity was 93.3%.Conclusion The relative content of oligosaccharide chain components(G-test value)is higher than that of tumor markers AFP and PIVKA-Ⅱin the diagnosis of primary liver cancer.It has the most significance in single detection,but the sensitivity of alpha-fetoprotein AFP is still the highest.The detection rate can be increased when using combined detection.The overall performance of this new type of oligosaccharide chain test(G-test value)has a higher detection rate and clinical significance for the primary liver cancer,comparing with the traditional primary liver cancer tumor markers.