G-test在肝细胞癌筛查中的诊断价值

The diagnostic value of G-test in the early screening for primary hepatocellular carcinoma

目的提高肝细胞癌(hepatocellular carcinoma,HCC)患者的诊断对其生存率具有重要的意义。甲胎蛋白(alpha-fetoprotein,AFP)普遍应用于HCC的筛查与诊断,但是其敏感度和特异度存在不足,因此有必要进一步筛选相关标记物提高HCC的诊断率。方法对临床诊断为HCC患者及考虑存在HCC高危因素的慢性肝病患者中,对比分析荧光毛细血管法寡糖链检测(G-test)和AFP单独或联合应用于HCC的诊断率。结果本研究共纳入73名HCC及考虑存在HCC高危因素的非HCC慢性肝病患者。经病理学或影像学联合AFP确诊HCC患者30人。受试者操作特征曲线(ROC)下面积(AUC)分析得到:单独检测G-test(AUC:0.701)和AFP(AUC:0.680)二者的敏感性无显著差异(P=0.7648)。进一步研究发现G-test联合AFP(AUC:0.698)检测的灵敏度(90.0%)和特异度(93.0%)显著高于单独AFP的检测(AUC:0.671)。结论G-test联合AFP能够提高HCC的诊断率。

Objective Early diagnosis is of vital clinical significance in promoting survival in patients with primary hepatocellular carcinoma(HCC).Alpha-fetoprotein(AFP)has been widely applied in the diagnosis of primary HCC,but its sensitivity and specificity are unsatisfactory.Therefore,it is necessary to identify novel diagnostic biomarkers to improve the diagnosis efficacy.Methods Patients with clinically diagnosed HCC or at high risk of HCC in our hospital from January 2019 to August 2019 were enrolled.The diagnostic value of AFP,oligosaccharide chain detection(G-test),and their combination for HCC was analyzed.Results A total of 73 patients were included.Among them,30 HCC patients were confirmed by pathology or imaging combined with AFP.The area under the receiver operating characteristic curve(ROC-AUC)of G-test was 0.701,and the ROC-AUC of AFP was 0.680.There was no significant difference in the sensitivity between them(P=0.7648).Furthermore,the ROC-AUC of the combination of G-test and AFP was 0.671.The sensitivity and the specificity of the combination were 90.0%and 93.0%,which were significantly higher those of AFP alone.Conclusion G-test combined with AFP could improve diagnostic yield for HCC.