血清PIVKA-Ⅱ与AFP联合检测在原发性肝癌临床诊断中的应用

Application of serum PIVKA-Ⅱand AFP in clinical diagnosis of primary hepatocellular carcinoma

目的探讨血清异常凝血酶原(PIVKA-Ⅱ)与甲胎蛋白(AFP)联合检测对原发性肝癌(PHC)患者的临床诊断价值。方法收集2016年2月至2018年1月在该院住院的607例患者血清,其中有141例PHC患者(PHC组),152例肝硬化患者(肝硬化组),164例慢性乙型肝炎患者(慢性乙型肝炎组)和150例体检健康者(健康对照组)。对4组血清标本的PIVKA-Ⅱ和AFP水平进行检测,利用SPSS17.0分析软件对本研究的所有检测数据进行统计学分析。结果PHC组血清PIVKA-Ⅱ和AFP水平均较肝硬化组、慢性乙型肝炎组和健康对照组更高,差异有统计学意义(P<0.01)。血清PIVKA-Ⅱ单项诊断PHC的灵敏度为78.72%,特异度为78.76%;血清AFP单项诊断PHC的灵敏度为68.09%,特异度为85.62%。PIVKA-Ⅱ与AFP进行联合检测时的灵敏度为83.69%,与单独AFP检测比较,差异有统计学意义(χ2=9.379,P<0.05)。结论血清PIVKA-Ⅱ在临床上对PHC诊断的灵敏度较AFP的灵敏度高,与AFP进行联合检测可提高对PHC诊断的灵敏度和特异度,为临床诊断提供重要依据。

Objective To investigate the significance of serum prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ)and alpha-fetoprotein(AFP)in clinical diagnosis of primary hepatocellular carcinoma(PHC).Methods A total of 607 samples from February 2016 to January 2018 were collected,including 141 cases of PHC(PHC group),152 cases of liver cirrhosis(liver cirrhosis group),164 cases with chronic hepatitis B(chronic hepatitis B group)and 150 cases of healthy controls(healthy control group).The levels of PIVKA-Ⅱand AFP in the serum samples of each group were measured,and all the data of this study were analyzed by SPSS17.0 software.Results The levels of serum PIVKA-Ⅱand AFP in PHC group were significantly higher than those in liver cirrhosis group,chronic hepatitis B group and healthy control group(P<0.01).The the sensitivity and specificity of serum PIVKA-Ⅱwere 78.72%and 78.76%for diagnosis of PHC,respectively,and sensitivity and specificity of serum AFP were 68.09%and 85.62%for diagnosis of PHC,respectively.The sensitivity of PIVKA-Ⅱcombined with AFP was 83.69%,which compared with AFP alone,the difference was statistically significant(χ2=9.379,P<0.05).Conclusion The sensitivity of serum PIVKA-Ⅱin clinical diagnosis of PHC was higher than that of AFP.Combination of serum PIVKA-Ⅱwith AFP can improve the diagnostic sensitivity and specificity for diagnosis of PHC,and provide an important basis for clinical diagnosis.