异常凝血酶原、恶性肿瘤特异性生长因子和糖类抗原199联合检测对肝脏良恶性结节或肿块诊断与鉴别诊断的价值

Application value of combined detection of abnormal prothrombin,malignant tumor-specific growth factor and carbohydrate antigen 199 in the diagnosis and differential diagnosis of benign and malignant nodules or masses liver diseases

目的:探讨异常凝血酶原(PIVKA-Ⅱ)、恶性肿瘤特异性生长因子(TSGF)、糖类抗原199(CA199)联合检测在诊断与鉴别诊断肝脏良恶性结节或肿块的应用价值。方法:选取2019年2月至2021年2月我院收治的131例肝脏肿瘤或结节患者作为研究对象,其中61例为原发性肝癌(PHC),称PHC组,70例为肝脏良性结节(或肿块)称肝脏良性结节(或肿块)组(简称良性结节组);另选取同期在我院体检的健康人员71例作为对照组。比较3组人员PIVKA-Ⅱ、TSGF、CA199水平差异,观察单一指标检测与3指标联合检测对诊断PHC和鉴别诊断肝脏良、恶性结节的差异,评估其诊断与鉴别诊断效能。进一步分析联合检测在PHC病理类型、临床分期中的诊断价值。结果:3组人员的3项指标单独检测值均是PHC组最高,良性结节组次之,对照组最低,组间比较均P<0.05。3项指标联合检测对PHC的诊断效能高于每个单项指标检测,P<0.05。联合检测对肝脏良、恶性肿块或结节的鉴别诊断效能高于单项检测。联合检测有助于PHC患者病理类型,临床分期的诊断。结论:PIVKA-Ⅱ、TSGF、CA199联合检测能提高PHC的诊断准确性、敏感性,有助于提高PHC病理类型、临床分期的鉴别。联合检测能提高肝脏良、恶性结节或肿块的鉴别诊断效能,为临床正确诊断与治疗提供依据。

Objective:To explore the value of combined detection of abnormal prothrombin(PIVKA-Ⅱ),malignant tumor-specific growth factor(TSGF),and carbohydrate antigen 199(CA199) in the diagnosis and differential diagnosis of benign and malignant nodules or masses liver diseases.Methods:A total of 131 patients with liver disease admitted to our hospital from June 2018 to January 2020 was selected and divided into two groups based on the pathological results.Among them,the primary liver cancer was 61 cases(PHC group),and the benign nodules or masses of liver diseases were 70 cases(he benign nodules or masses of liver diseases group).Another 71 healthy people who were examined in our hospital during the same period were selected as the control group.Compare the levels of PIVKA-Ⅱ,TSGF,and CA199 in the three groups,evaluate the level differences between single detection and combined detection in PHC and benign liver disease nodules,in view of the highest diagnostic efficiency of PIVKA-Ⅱ detection and combined detection in PHC,and evaluate its diagnostic efficacy for PHC,and then further analyze the combined detection in PHC pathological types,The value of differential diagnosis in clinical staging.Results:The levels of PIVKA-Ⅱ,TSGF and CA199 from high to low are:PHC group> benign nodules or masses of liver diseases group >control group(P<0.05).The diagnostic value of PIVKA-Ⅱ+TSGF+CA199 in PHC was significantly higher than that in benign nodules or masses of liver disease(P<0.05);among the single tumor markers,the diagnostic efficiency of PIVKA-Ⅱ was the best.The differential diagnosis effect of PIVKA-Ⅱ + TSGF + CA199 on HCC patients and early PHC patients was significantly higher than that of PIVKA-Ⅱ( P <0.05).Conclusion:The combined detection of PIVKA-Ⅱ + TSGF + CA199 is helpful to the differential diagnosis of benign and malignant nodules or masses of liver disease and the diagnosis of PHC with different pathological types and clinical stages.