SAA、AFP、PIVKAⅡ联合检测在原发性肝癌诊断中的价值

The Value of Combined Detection of SAA,AFP and PIVKAⅡ in the Diagnosis of Primary Hepatocarcinoma

目的:探索联合检测血清淀粉样蛋白A(serum amyloid A,SAA)、甲胎蛋白(alpha fetoprotein,AFP)和维生素K拮抗剂-Ⅱ诱导蛋白(protein induced by vitamin k absence or antagonist-Ⅱ,PIVKAⅡ)在原发性肝癌中的诊断价值。方法:采集原发性肝癌患者、其他肝病患者、健康体检者血清,检测SAA、AFP、PIVKAⅡ的表达情况,统计分析SAA、AFP、PIVKAⅡ单独及联合检测诊断原发性肝癌的灵敏度、特异度,评价其诊断价值。结果:原发性肝癌组SAA、AFP、PIVKAⅡ浓度水平均显著高于其他肝病组和健康对照组,差异有统计学意义(P<0.01)。两项联合检测时,SAA+AFP串联检测的特异度98.18%,SAA/AFP并联检测的灵敏度88.89%;SAA+PIVKAⅡ串联检测的特异度96.36%,SAA/PIVKAⅡ并联检测的灵敏度85.56%。三项联合检测时,SAA+AFP+PIVKAⅡ串联检测的特异度99.09%,SAA/AFP/PIVKAⅡ并联检测的灵敏度92.22%,诊断效率得到了提高。结论:联合检测SAA、PIVKAⅡ、AFP在原发性肝癌的诊断中具有较高灵敏度和特异度,可作为一种联合诊断方案应用于临床。

Objective:To investigate the diagnostic value of combined detection of serum amyloid A (SAA),alpha fetoprotein (AFP) and protein induced by vitamin K antagonist or antagonistⅡ (PIVKAⅡ) in primary hepatocarcinoma.Method:The expression levels of SAA,AFP and PIVKAⅡ of patients with primary hepatocarcinoma,other hepatopathy patients and healthy people were detected.Analyzed the sensitivity and specificity of the three indicators alone and combination detection in the diagnosis of primary hepatocarcinoma.Result:The expression levels of SAA,AFP and PIVKAⅡ in primary hepatocarcinoma group were significantly higher than those in the other hepatopathy group and healthy control group,the difference was statistically significant (P<0.01).The specificity of SAA+AFP serial detection was 98.18%,the sensitivity of SAA/AFP parallel detection was 88.89%,the specificity of SAA+PIVKAⅡ serial detection was 96.36%,the sensitivity of SAA/PIVKAⅡ parallel detection was 85.56%.The specificity of SAA+AFP+PIVKAⅡ was 99.09%,and the sensitivity of SAA/AFP/PIVKAⅡ was 92.22%.Conclusion:The combined detection of SAA,AFP and PIVKAⅡ has high sensitivity and specificity in the diagnosis of primary hepatocarcinoma,which can be used as a combined diagnostic scheme in clinical practice.