血清TK1、VEGF和AFP检测对原发性肝癌诊断及预后评估的价值

The value of serum TK1,VEGF and AFP in diagnosis and prognosis evaluation of primary hepatocellular carcinoma

目的探讨血清胸苷激酶1(TK1)、血管内皮生长因子(VEGF)、甲胎蛋白(AFP)检测对原发性肝癌(PHC)诊断及预后评估的价值.方法选取73例PHC患者(PHC组)、95例良性肝病患者(良性组)及50例健康志愿者(健康组)为研究对象,对比3组血清TK1、VEGF和AFP水平差异,通过ROC曲线分析血清TK1、VEGF和AFP检测对PHC的诊断价值,探索血清TK1、VEGF和AFP表达与PHC患者3年预后的关系.结果PHC组患者血清TK1、VEGF及AFP水平均显著高于良性组及健康组(P<0.05).血清TK1、VEGF及AFP高表达是导致PHC发生的重要危险因素(P<0.05).血清TK1、VEGF及AFP检测对PHC诊断的ROC曲线下面积分别为0.888、0.868、0.861,最佳临界值分别为2.25 pmol/L、150.11 ng/L、25.85μg/L.血清TK1、VEGF及AFP联合检测的灵敏度显著高于各指标单独检测(P<0.05),而联合检测特异度与单独检测差异无统计学意义(P>0.05).TK1、VEGF及AFP高表达组3年生存率显著低于低表达组,生存时间也小于低表达组(P<0.05).结论血清TK1、VEGF及AFP高表达与PHC的发生密切相关,联合检测TK1、VEGF及AFP表达情况可提高PHC诊断灵敏度,且有助于评估患者预后.

Objective To investigate the value of serum thymidine kinase 1(TK1)and vascular endothelial growth factor(VEGF)and alpha-fetoprotein(AFP)in diagnosis and prognostic evaluation of primary hepatocellular carcinoma(PHC).Methods 73 patients with PHC(PHC group),95 patients with benign liver disease(benign group)and 50 healthy volunteers(healthy group)were selected as research objects.The differences of serum TK1,VEGF and AFP levels in three groups were compared.The diagnostic value of TK1,VEGF and AFP for PHC was analyzed by ROC curve.The relationships between serum TK1,VEGF and AFP expressions and survival status of PHC patients were explored.Results The levels of TK1,VEGF and AFP in the PHC group were significantly higher than those in the benign group and healthy group(P<0.05).High expression of serum TK1,VEGF and AFP is an important risk factor for PHC(P<0.05).The area under the ROC curve of TK1,VEGF and AFP for PHC diagnosis was 0.888,0.868 and 0.861,with the optimal critical values were 2.25 pmol/L,150.11 ng/L,25.85μg/L,respectively.The sensitivity of TK1,VEGF and AFP combined detection was significantly higher than that of individual detection(P<0.05),while the specificity of combined detection was not statistically different from individual detection(P>0.05).The 3-year survival rate of the high expression group of TK1,VEGF and AFP was significantly lower than that of the low expression group,and the survival time of the high expression group was also lower than the low expression group(P<0.05).Conclusion The high expression of serum TK1,VEGF and AFP is closely related to the occurrence of PHC.Detection of TK1,VEGF and AFP can improve the diagnostic sensitivity of PHC and help to evaluate the prognosis.