抗核抗体与甲胎蛋白在原发性肝癌中的诊断及预后评估价值

Diagnostic and prognostic value of antinuclear antibody and alpha-fetoprotein in primary liver cancer

目的探究抗核抗体(ANA)与甲胎蛋白(AFP)在原发性肝癌中的诊断及预后评估价值。方法选取2016年10月至2018年6月赣州市肿瘤医院收治的142例肝病患者为研究对象,根据患者病理检查结果分为原发性肝癌组(65例)和非肿瘤性肝病组(77例),分别采用电化学发光法和ELISA法检测AFP、ANA水平,比较两组AFP、ANA水平,计算各指标单独及联合的诊断价值,并分析AFP、ANA表达水平对原发性肝癌患者预后的预测价值。结果原发性肝癌组患者血清ANA和AFP水平均高于非肿瘤性肝病组,差异有统计学意义(P<0.05)。ANA和AFP联合诊断原发性肝癌的敏感度、特异度和准确度分别为84.62%、83.11%、83.80%,其敏感度和准确度均高于单项检测指标,差异有统计学意义(P<0.05);随访结束,65例原发性肝癌患者41例出现疾病进展,其中疾病进展患者的ANA和AFP水平均高于无疾病进展者,差异有统计学意义(P<0.05);ROC曲线分析显示,ANA、AFP单项及联合检测对原发性肝癌患者预后评估的AUC分别为0.759、0.789、0.892,联合检测AUC高于单项检测,差异有统计学意义(P<0.05)。结论ANA和AFP在原发性肝癌中存在异常表达,二者联合检测对于原发性肝癌的诊断和预后均有较高的评估价值。

Objective To explore the value of anti-nuclear antibody(ANA)and alpha-fetoprotein(AFP)in the diagnosis and prognosis evaluation of primary liver cancer.Methods A total of 142 patients with liver disease admitted to Ganzhou Cancer Hospital from October 2016 to June 2018 were selected as the research subjects,and divided into primary liver cancer group(65 cases)and non-neoplastic liver disease group(77 cases)according to the pathological examination results.The levels of AFP and ANA were detected by electrochemiluminescence and ELISA,respectively.The levels of AFP and ANA were compared between the two groups,and the diagnostic value of each index alone and combined was calculated.The prognostic value of AFP and ANA expression levels in patients with primary liver cancer was analyzed.Results The levels of serum ANA and AFP in primary liver cancer group were higher than those in non-tumor liver disease group,the differences were statistically significant(P<0.05).The sensitivity,specificity and accuracy of ANA combined with AFP in the diagnosis of primary liver cancer were 84.62%,83.11%and 83.80%,respectively.Its sensitivity and accuracy were higher than those of single index,the differences were statistically significant(P<0.05).At the end of follow-up,there were 41 cases with disease progression in the 65 patients with primary liver cancer.The levels of ANA and AFP in patients with disease progression were higher than those without disease progression,the differences were statistically significant(P<0.05).ROC curve analysis showed that the AUC values of ANA,AFP and their combination for evaluating prognosis of patients with primary liver cancer were 0.759,0.789 and 0.892,respectively.AUC of combined detection was significantly higher than that of single index,the difference was statistically significant(P<0.05).Conclusion ANA and AFP are abnormally expressed in primary liver cancer.The combined detection of the two indexes is of high value in the diagnosis and prognosis evaluation of primary liver cancer.