血清维生素K缺乏或拮抗剂Ⅱ诱导蛋白和甲胎蛋白水平在慢性丙型肝炎、肝硬化和原发性肝癌中的比较

Serum vitamin K deficiency or antagonistⅡinduced proteins and alpha-fetoprotein levels in chronic hepatitis C,liver cirrhosis and primary liver cancer

目的分析比较血清维生素K缺乏或拮抗剂Ⅱ诱导蛋白(PIVKA-Ⅱ)和甲胎蛋白(AFP)在慢性丙型肝炎、肝硬化和原发性肝癌中的水平变化,以探讨PIVKA-Ⅱ和AFP在不同肝病诊断中的应用价值。方法检测分析63例慢性丙型肝炎患者、60例肝硬化患者和66例原发性肝癌患者血清PIVKA-Ⅱ和AFP水平,与正常对照组进行均值比较;再分别统计PIVKA-Ⅱ和AFP在不同病例组中的阳性率,并进行分析比较。结果慢性丙型肝炎、肝硬化和原发性肝癌组血清中2项指标均值都高于正常对照组(P<0.01);慢性丙型肝炎、肝硬化组和原发性肝癌组之间比较,原发性肝癌组PIVKA-Ⅱ和AFP明显高于其他2组(P<0.01);按不同疾病比较,PIVKA-Ⅱ和AFP在原发性肝癌组中均高于慢性丙型肝炎和肝硬化组,组间比较差异有统计学意义(P<0.01)。结论血清PIVKA-Ⅱ和AFP在慢性丙型肝炎、肝硬化和原发性肝癌组中均有升高,原发性肝癌组升高最为明显;诊断阳性率也在原发性肝癌组中最高,PIVKA-Ⅱ及AFP均为原发性肝癌患者早期诊断很好的血清学指标。

Objective To analyze and compare the changes of serum vitamin K deficiency or antagonistⅡinducible protein(PIVKA-Ⅱ)and alpha-fetoprotein(AFP)in hepatitis C(HCV),cirrhosis and primary liver cancer(PHC).To evaluate the value of PIVKA-Ⅱand AFP in the diagnosis of different liver diseases.Methods Serum PIVKA-Ⅱand AFP levels were measured and analyzed in 63 patients with hepatitis C,60 patients with liver cirrhosis and 66 patients with primary liver cancer,and the positive rates of PIVKA-Ⅱand AFP in different case groups were calculated.The results were analyzed and compared.Results The mean values of two indexes in serum of patients with hepatitis C,liver cirrhosis and primary liver cancer were higher than those of the controls(P<0.01).Compared with hepatitis C,cirrhosis and primary liver cancer,PIVKA-Ⅱand AFP in primary liver cancer group were significantly higher than those in the other two groups.The positive rate of PIVKA-Ⅱwas higher than that of AFP in patients with hepatitis C,liver cirrhosis and primary liver cancer,and the positive rate of diagnosis was higher in patients with primary liver cancer than that in patients with hepatitis C and liver cirrhosis.However,there was no statistical significance on the difference between AFP and PIVKA-Ⅱ(P>0.05).According to the comparison of different diseases,PIVKA-Ⅱand AFP in the primary liver cancer group were higher than those in the hepatitis C and liver cirrhosis groups,with the differences statistically significant(P<0.01).Conclusion Serum PIVKA-Ⅱand AFP levels are increased in patients with hepatitis C,liver cirrhosis and primary liver cancer.The increase is most obvious in the primary liver cancer group,and the positive rate of diagnosis is also the highest in the primary liver cancer group.PIVKA-Ⅱand AFP are good serological indicators for the early diagnosis of primary liver cancer.