AFP与TAP联合检测在肝细胞癌中的临床应用研究

Study on the Clinical application of combined detection of AFP and TAP in hepatocellular carcinoma

目的探讨甲胎蛋白(AFP)联合肿瘤异常蛋白(TAP)检测在肝细胞癌(HCC)中的诊断价值。方法采用回顾性分析的方法,收集郑州大学第一附属医院2018年10月至2019年10月收治的HCC、肝硬化、慢性乙型肝炎(简称乙肝)患者各70例,分别作为HCC组、肝硬化组、慢性乙肝组。比较各组AFP及TAP水平差异,分析血清AFP与TAP的关系,采用受试者工作特征曲线(ROC曲线)评价AFP与TAP诊断HCC的临床价值。结果HCC组血清TAP、AFP水平高于肝硬化组、慢性乙肝组,差异有统计学意义(P<0.05)。AFP与TAP联合检测诊断HCC的曲线下面积(AUC)为0.893(95%CI:0.843~0.932),大于AFP、TAP单独检测诊断HCC的AUC[0.772(95%CI:0.709~0.827)、0.848(95%CI:0.792~0.893)],差异具有统计学意义(P<0.05)。TAP单独检测诊断AFP阴性HCC的AUC为0.842(95%CI:0.779~0.893),最佳临界值为115.72μm 2,灵敏度和特异度分别为82.9%和77.9%。在HCC的诊断上AFP与TAP无相关性(r=-0.063,P>0.05)。结论AFP与TAP联合检测对HCC有良好的诊断效能,尤其对于AFP阴性的HCC患者,TAP仍有重要的诊断价值。

Objective To investigate the diagnostic value of alpha-fetoprotein(AFP)combined with tumor abnormal protein(TAP)detection in hepatocellular carcinoma(HCC).Methods A retrospective analysis method was used to collect 70 patients with HCC,70 patients with liver cirrhosis and 70 patients with chronic hepatitis B who were admitted to the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2019,as HCC group,liver cirrhosis group and chronic hepatitis B group.The levels of AFP and TAP in each group were compared,and the relationship between serum AFP and TAP was analyzed.Receiver operating characteristic curve(ROC curve)was used to evaluate the clinical value of AFP and TAP in the diagnosis of HCC.Results The levels of serum TAP and AFP in the HCC group were higher than those in the cirrhosis group and the chronic hepatitis B group,and the differences were statistically significant(P<0.05).The area under the curve(AUC)of the combined detection of AFP and TAP for the diagnosis of HCC was 0.893(95%CI:0.843-0.932),which was higher than that of AFP and TAP alone for the diagnosis of HCC[0.772(95%CI:0.709-0.827),0.848(95%CI:0.792-0.893)],the differences were statistically significant(P<0.05).The AUC of TAP alone for the diagnosis of AFP-negative HCC was 0.842(95%CI:0.779-0.893),the best cut-off value was 115.72μm 2,and the sensitivity and specificity were 82.9%and 77.9%,respectively.There was no correlation between AFP and TAP in the diagnosis of HCC(r=-0.063,P>0.05).Conclusion The combined detection of AFP TAP has a good diagnostic efficacy for HCC.TAP still has important diagnostic value,especially for AFP negative HCC patients.