AFP、GGT、AST/ALT在肝细胞癌中的诊断价值研究

The Value of AFP、GGT、AST/ALT in Hepatocellular Carcinoma

目的探讨甲胎蛋白(AFP)、γ-谷氨酰基转移酶(GGT)、天冬氨酸氨基转移酶和丙氨酸氨基转移酶比值(AST/ALT)联合检测在肝细胞癌(HCC)中的临床诊断价值。方法将2019年1月至2019年12月在广西医科大学第一附属医院接受治疗的肝细胞癌患者选定为研究小组,选择同一时期肝硬化和健康体检者作为对照群体,共245例,其中肝细胞癌组(HCC)110例、肝硬化组(LC)52例、健康组(HG)83例。运用电化学发光法检测其AFP、GGT、AST/ALT含量,并绘制受试者工作特征曲线(ROC)回顾性分析其在HCC中的诊断价值。结果肝细胞癌组患者AFP、GGT、AST/ALT水平均高于肝硬化组和健康体检组,肝细胞癌组与肝硬化组、健康体检组分别比较,AFP、AST/ALT差异均有统计学意义(P<0.05)。肝细胞癌组、肝硬化组与健康体检组相比,三项指标差异均有统计学意义。AFP、GGT、AST/ALT单独诊断肝细胞癌时的AUC分别为0.840(95%CI 0.781-0.899)、0.804(95%CI 0.744-0.864)、0.805(95%CI 0.744-0.866),其中AFP具有最佳诊断性能,AUC最大,差异具有统计学意义(P<0.05)。联合检测时AFP+GGT+AST/ALT的AUC最大,为0.953(95%CI 0.926-0.981),优于单独检测。结论GGT、AFP、AST/ALT对肝细胞癌具有重要的诊断价值,联合检测优于单独检测。

Objective To explore the combined detection of alpha-fetoprotein(AFP),γ-glutamyl transferase(GGT),aspartate aminotransferase and alanine aminotransferase ratio(AST/ALT)in hepatocellular carcinoma(HCC)The value of clinical diagnosis.Methods The patients with hepatocellular carcinoma admitted in the First Affiliated Hospital of Guangxi Medical University from January 2019 to December 2019 were collected as the research group,and cirrhosis and healthy physical examination patients were selected as the control group.There were 110 cases in the cancer group(HCC),52 cases in the cirrhosis group(LC)and 83 cases in the healthy group(HG).The content of AFP,GGT,AST/ALT was detected by electrochemiluminescence method,and draw the receiver operating characteristic curve(ROC)and analyze its diagnostic value in HCC retrospectively.Results The levels of AFP,GGT,and AST/ALT in the hepatocellular carcinoma group were higher than those in the cirrhosis group and the healthy physical examination group.The hepatocellular carcinoma group was compared with the cirrhosis group and the healthy physical examination group.Academic significance(P<0.05).The hepatocellular carcinoma group and liver cirrhosis group compared with the healthy physical examination group,the three indicators were significantly different.The AUC for AFP,GGT,and AST/ALT in the diagnosis of hepatocellular carcinoma alone were 0.840(95%CI 0.781-0.899),0.804(95%CI 0.744-0.864),0.805(95%CI 0.744-0.866),of which AFP had The best diagnostic performance,the largest AUC,the difference was statistically significant(P<0.05).AFP+GGT+AST/ALT had the largest AUC of 0.953(95%CI 0.926-0.981)during the combined test,which was superior to the single test.Conclusion GGT,AFP,AST/ALT have important diagnostic value for hepatocellular carcinoma,combined detection is better than single detection.