AFP、CEA、PIVKA-Ⅱ与外周血NLR联合检测对原发性肝癌的诊断价值

The diagnostic value of combined test of AFP,CEA,PIVKA-Ⅱand peripheral blood NLR for primary liver cancer

目的探讨血清甲胎蛋白(AFP)、癌胚抗原(CEA)、异常凝血酶原(PIVKA-Ⅱ)与外周血中性粒细胞淋巴细胞比值(NLR)联合检测对原发性肝癌的诊断价值。方法选取2019年6月至2020年6月长江大学附属仙桃市第一人民医院检验科收治的40例原发性肝癌患者(A组)和50例肝硬化患者(B组),另选取同一时期于我院进行健康体检的80例健康人员(C组)作为研究对象,比较三组人员的AFP、CEA、PIVKA-Ⅱ、NLR水平,不同分期患者的指标水平,不同检测指标的敏感度、特异度、准确率。结果A组受检者的AFP、CEA、PIVKA-Ⅱ、NLR水平明显高于B组和C组(P<0.05);B组受检者的AFP、CEA、PIVKA-Ⅱ、NLR水平也明显高于C组(P<0.05);Ⅲ~Ⅳ期患者的AFP、CEA、PIVKA-Ⅱ、NLR水平高于Ⅰ~Ⅱ期患者(P<0.05);AFP、CEA、PIVKA-Ⅱ与NLR联合检测的敏感度、特异度、准确率分别为92.50%、96.15%、95.29%,与单一指标检测比较,差异有统计学意义(P<0.05)。结论AFP、CEA、PIVKA-Ⅱ、NLR水平的高低与原发性肝癌发生有密切的关联,四项指标联合检测具有更高的敏感度、特异度、准确率,值得临床推广及应用。

Objective To investigate the diagnostic value of combined test of serum alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),abnormal prothrombin(PIVKA-Ⅱ)and peripheral blood neutrophil-to-lymphocyte ratio(NLR)on primary liver cancer.Methods 40 patients with primary liver cancer(Group A)and 50 patients with cirrhosis(Group B)who were admitted to the Department of Clinical Laboratory in Xiantao First People’s Hospital Affiliated to Yangtze University from June 2019 to June 2020,and another 80 healthy persons who underwent health examinations in the hospital during the same period(Group C)were selected as study subjects.The AFP,CEA and PIVKA-Ⅱlevels,NLR,indicator levels of patients with different stages,as well as the sensitivity,specificity and accuracy of different test indicators were compared among the three groups.Results The AFP,CEA and PIVKA-Ⅱlevels,and NLR of Group A testees were significantly higher than those of Group B and Group C testees(P<0.05).The levels of AFP,CEA,PIVKA-Ⅱand NLR of Group B testees were significantly higher than those of Group C testees(P<0.05).The AFP,CEA and PIVKA-Ⅱlevels,and NLR in stageⅢ-Ⅳpatients were higher than those in stageⅠ-Ⅱpatients(P<0.05).The sensitivity,specificity,and accuracy of the combined test of AFP,CEA,PIVKA-Ⅱand NLR were 92.50%,96.15%,and 95.29%respectively,with statistically significant differences from those of single indicator test(P<0.05).Conclusion The AFP,CEA and PIVKA-Ⅱlevels and NLR are closely associated with the occurrence of primary liver cancer,and the combined test of the four indicators shows higher sensitivity,specificity and accuracy,which is worthy of clinical promotion and application.