血清热休克蛋白90α与甲胎蛋白异质体检测对肝细胞肝癌的诊断价值研究

Diagnostic value of serum heat shock protein 90αand alpha-fetoprotein L3 in hepatocellular carcinoma

目的:分析血清中热休克蛋白90α(Hsp90α)、甲胎蛋白异质体L3(AFP-L3)及甲胎蛋白(AFP)联合检测在肝细胞肝癌诊断中的临床应用价值。方法:选取2020年1月至2021年8月在甘肃省中医院肝病科就诊的113例肝细胞肝癌患者及165例慢性乙型肝炎患者为研究对象,选取同期在院进行体检的188例健康人群为对照组。采用罗氏cobas8000电化学发光系统测定所有人群血清AFP-L3及AFP水平;以酶联免疫吸附法测定各组血清Hsp90α水平。结果:肝细胞肝癌与慢性乙型肝炎患者血清Hsp90α、AFP-L3及AFP水平高于健康对照人群(P<0.05)。三种血清标志物联合检测诊断肝细胞肝癌的灵敏度、特异度及约登指数均最大,ROC曲线下面积为0.945,其诊断价值最高。结论:联合检测血清Hsp90α、AFP-L3及AFP能显著提升肝细胞肝癌的诊断符合率,弥补单项检测的不足,提升诊断价值。

Objective:To explore the value of combined detection of heat shock protein 90α(Hsp90α),alpha-fetoprotein L3(AFP-L3)and alpha-fetoprotein(AFP)in the diagnosis of hepatocellular carcinoma.Methods:A total of 278 hepatocellular carcinoma patients were selected as the study subjects from January 2020 to July 2021,and 188 healthy subjects during the same period were selected as the control group.The serum levels of alpha-fetoprotein heterogeneity L3 and AFP were determined by Roche cobas 8000 analysis system.The serum levels of Hsp90αwere determined by enzyme-linked immunosorbent assay.ROC curve was used to analyze the diagnostic efficacy of Hsp90αand AFP-L3.Results:The serum levels of Hsp90α,AFP-L3 and AFP in patients with hepatocellular carcinoma and chronic hepatitis B were significantly higher than healthy subjects(P<0.05).The combined detection of Hsp90α,AFP-L3 and AFP has the highest sensitivity,specificity and Youden index in diagnosing primary liver cancer,which has the highest diagnostic value(AUC=0.945).Conclusion:The combined detection of serum Hsp90α,AFP-L3 and AFP can significantly increase the diagnostic coincidence rate of primary liver cancer,and enhance the diagnostic value.