血清AFP、PIVKA-Ⅱ、GP73、IL-6联合检测原发性肝癌的临床价值

CLINICAL VALUE OF SERUM AFP,PIVKA-Ⅱ,GP73 AND IL-6 IN DIAGNOSIS OF PRIMARY HEPATIC CARCINOMA

目的探讨血清标志物甲胎蛋白(AFP)、异常凝血酶原(PIVKA-Ⅱ)、高尔基体蛋白(GP73)和白介素6(IL-6)联合检测在原发性肝癌筛查中的临床价值。方法选取2019年5月—2020年5月在该院确诊的原发性肝癌患者123例(PHC组),同时选取我院肝硬化患者30例(LC组),健康体检中心健康体检人群50例(健康组),检测血清中的AFP、PIVKA-Ⅱ、GP73和IL-6水平。结果PHC组AFP和PIVKA-Ⅱ高于LC组,AFP、PIVKA-Ⅱ、GP73和IL-6高于健康组;LC组GP73和IL-6高于健康组,差异均有统计学意义(P<0.05);四项联合检测的AUC略高于PIVKA-Ⅱ、GP73和IL-6三项联合检测,其三项联合检测的阳性率高于单项指标阳性率,差异均有统计学意义(P<0.05);PIVKA-Ⅱ、GP73和IL-6三项联合检测时,AUC(95%CI)为0.886(0.841-0.931),敏感性为88.62%,特异性为76.25%,相对单项检测提高了检出率,相对四项检测简单便捷。结论血清PIVKA-Ⅱ、GP73和IL-6三项联合检测可提高原发性肝癌的检出率,对早期原发性肝癌患者的筛查有重要价值。

Objective To investigate the clinical value of serum marker alpha-fetoprotein(AFP),abnormal prothrombin(PIVKA-Ⅱ),Golgi Protein(GP73)and interleukin-6(IL-6)in the screening of primary hepatic carcinoma.Methods A total of one hundred twenty three patients with primary hepatic carcinoma diagnosed in our hospital from May 2019 to May 2020(PHC group),30 patients with cirrhosis in our hospital(LC group)and 50 healthy people in the health examination center(healthy group)were selected to detect the levels of AFP,PIVKA-Ⅱ,GP73 and IL-6 in serum.Results AFP and PIVKA-Ⅱin serum of PHC group were higher than those of LC group,AFP,PIVKA-Ⅱ,GP73 and IL-6 were higher than those of LC group,and GP73 and IL-6 in LC group were higher than those of LC group,and the differences were statistically significant(P<0.05);The AUC of the four combined tests was slightly higher than that of PIVKA-Ⅱ,GP73 and IL-6 combined tests,and the positive rate of the three combined tests was higher than that of the single indicator,and the difference was statistically significant(P<0.05);When PIVKA-Ⅱ,GP73 and IL-6 were combined,the AUC(95%CI)was 0.886(0.841-0.931),the sensitivity was 88.62%,and the specificity was 76.25%.Compared with the single test,the detection rate was improved;compared with the four tests,it was simple and convenient.Conclusion Combined detection of serum PIVKA-Ⅱ,GP73 and IL-6 can improve the detection rate of primary liver cancer,which is of great value for the diagnosis of patients with early primary liver cancer.