联合血清AFP-L3%和DCP在AFP低水平HCC诊断中的作用

Role of serum AFP-L3% and DCP combination in the diagnosis of HCC with low concentration of AFP

目的探讨血清甲胎蛋白异质体比率(AFP-L3%)、异常凝血酶原(DCP)对甲胎蛋白(AFP)低水平肝细胞癌(HCC)的诊断价值。方法采用回顾性研究方法,纳入2020年1月至2021年2月在该院就诊的120例低水平AFP患者作为研究对象,其中HCC组47例、非HCC患者73例(包括良性肝病组40例,健康对照组33例),测定血清AFP-L3%、DCP水平并进行统计分析。结果 HCC组、良性肝病组、健康对照组血清AFP、AFP-L3%和DCP水平比较,差异均有统计学意义(P<0.05);AFP-L3%诊断AFP低水平HCC的灵敏度为78.72%、特异度为96.97%;DCP诊断AFP低水平HCC的灵敏度为78.72%、特异度为100.00%;联合检测AFP-L3%和DCP诊断AFP低水平HCC的曲线下面积(AUC)为0.953,明显高于AFP和AFP-L3%单独诊断,差异均有统计学意义(Z=2.577,P=0.010;Z=2.459,P=0.014),与单独DCP诊断比较差异无统计学意义(Z=1.804,P=0.071)。结论在AFP低水平HCC诊断上,DCP或优于AFP-L3%,两者联合检测有助于提高AFP低水平HCC的诊断效能,为AFP低水平HCC早期诊断提供可靠依据。

Objective To explore the diagnosis value of serum alpha-fetoprotein-L3 ratio(AFP-L3%)and Des-γ-carboxyprothrombin(DCP)in hepatocellular carcinoma(HCC)patients with low concentration of AFP.Methods Using retrospective study method, 47 cases with HCC and 73 cases without HCC [including benign liver disease group(40 cases) and control group(33 cases)]with low concentration of AFP from January 2020 to February 2021 in a Hospital were enrolled.Serum AFP-L3% and DCP concentrations were measured and statistically analyzed.Results The serum AFP,AFP-L3% and DCP levels of HCC group, benign liver disease group and healthy control group were significantly different(P<0.05).Serum AFP-L3% had a sensitivity of 78.72% and a specificity of 96.97% in the diagnosis of HCC with low concentration of AFP,while DCP had a sensitivity of 78.72% and a specificity of 100.00%.The area under the curve for combined detection of AFP-L3% and DCP was 0.953,which was significantly higher than that of AFP and AFP-L3%(Z=2.577,P=0.010;Z=2.459,P=0.014),but not significant higher than DCP(Z=1.804,P=0.071).Conclusion The combined detection of AFP-L3% and DCP can improve the diagnostic efficiency of HCC with low concentration of AFP,and provide reliable basis for the early diagnosis of HCC with low concentration of AFP.