血清甲胎蛋白和胆碱酯酶水平与肝硬化合并肝癌患者Child-Pugh分级的相关性分析

Correlation analysis of serum alpha-fetoprotein and cholinesterase levels with Child-Pugh grade in patients with liver cirrhosis and hepatocellular carcinoma

目的 探究血清甲胎蛋白(AFP)、胆碱酯酶(ChE)水平与肝硬化(LC)合并肝癌(HCC)患者Child-Pugh分级的相关性。方法 选取2019年3月至2020年3月本院收治的60例LC合并HCC患者作为LC合并HCC组,另选取同期60例LC失代偿期患者作为LC失代偿期组,60名健康体检者作为健康组。3组均检测血清AFP、ChE水平,并进行Child-Pugh分级评定,比较3组血清AFP、ChE水平及LC合并HCC组不同Child-Pugh分级血清AFP、ChE水平,分析血清AFP、ChE水平与Child-Pugh分级相关性及血清AFP、ChE单一检测、联合检测的诊断准确度。结果 LC合并HCC组血清AFP水平高于LC失代偿期组、健康组,且LC失代偿期组高于健康组(P<0.05);LC合并HCC组血清ChE水平低于LC失代偿期组、健康组,且LC失代偿期组低于健康组(P<0.05)。LC合并HCC组Child-Pugh分级:A级30例,B级18例,C级12例;随着Child-Pugh分级升高,血清AFP水平升高,血清ChE水平降低(P<0.05)。Pearson相关性分析显示,血清AFP水平与Child-Pugh分级呈正相关,血清ChE水平与Child-Pugh分级呈负相关(P<0.05)。血清AFP与ChE联合检测诊断LC合并HCC准确度为91.67%,高于AFP单一检测的76.67%和ChE单一检测的61.67%(P<0.05)。结论 LC合并HCC患者血清AFP、ChE水平会发生明显异常,且与Child-Pugh分级相关,能反映病情程度,二者联合检测可提高诊断准确性,有助于临床诊断及治疗方案的制订。

Objective To explore the correlation of serum alpha-fetoprotein(AFP) and cholinesterase(ChE) levels with Child-Pugh grade in patients with liver cirrhosis(LC) complicated with hepatocellular carcinoma(HCC). Methods A total of 60 patients with LC and HCC who were admitted to our hospital from March 2019 to March 2020 were selected as the LC combined HCC group, and 60 patients with LC decompensation during the same period were selected as the LC decompensation group, and 60 healthy subjects were selected as the healthy group. Serum AFP and ChE levels were detected among the three groups, and Child-Pugh grading was performed. The levels of serum AFP and ChE were compared among the three groups, and the serum AFP and ChE levels of different Child-Pugh grades in the LC combined HCC group were compared. The correlation between serum AFP and ChE levels and Child-Pugh grading and the diagnostic accuracy of serum AFP and ChE single detection and combined detection were analyzed. Results The serum AFP level in the LC combined with HCC group was higher than that in the LC decompensation group and the healthy group, and the LC decompensation group was higher than that in the healthy group(P<0.05);the level of serum ChE in the LC combined with HCC group was lower than that in the LC decompensation group and the healthy group, and the LC decompensation group was lower than that in the healthy group(P<0.05). Child-Pugh grade of LC combined with HCC group: 30 cases of grade A, 18 cases of grade B, and 12 cases of grade C;with the increase of Child-Pugh grade, the level of serum AFP increased and the level of serum ChE decreased(P<0.05). Pearson correlation analysis showed that serum AFP levels were positively correlated with Child-Pugh grades, and serum ChE levels were negatively correlated with Child-Pugh grades(P<0.05). The combined detection accuracy of serum AFP and ChE in the diagnosis of LC complicated with HCC was91.67%, which was higher than 76.67% of AFP single detection and 61.67% of ChE single detection(P<0.05). Conclusion Serum AFP and ChE levels in patients with LC combined with HCC are significantly abnormal, and they are correlated with Child-Pugh classification, which can reflect the severity of the disease. The combined detection of the two can improve the diagnostic accuracy and contribute to clinical diagnosis and formulation of treatment plan.