异常凝血酶原复合物在甲胎蛋白阴性肝癌患者中的应用价值

Application value of protein induced by vitamin K antagonist-Ⅱ in patients with alpha fetoprotein negative hepatocellular carcinoma

目的 探讨异常凝血酶原复合物(PIVKA-Ⅱ)在甲胎蛋白(AFP)阴性肝癌患者中的应用价值。方法 选择2019年1月~2021年6月我院连续收治的120例肝细胞癌(HCC)患者为研究对象。检测所有患者血清AFP、PIVKA-Ⅱ水平,且均接受肝动脉化疗栓塞术(TACE)治疗。根据AFP检测结果将入组患者分为AFP阴性组和AFP阳性组,比较两组基本临床特征以及治疗前后AFP、PIVKA-Ⅱ水平。采用Pearson检验分析AFP和PIVKA-Ⅱ表达的相关性。绘制受试者工作特性曲线(ROC),并计算曲线下面积(AUC)分析AFP、PIVKA-Ⅱ对两组患者近期疗效的评估价值。结果 两组患者年龄、性别、Child-Pugh分级、BCLC分期、分化程度、肿瘤大小、肿瘤数目比较差异无统计学意义(P>0.05)。治疗后AFP阳性组AFP水平显著高于AFP阴性组(P<0.05),两组PIVKA-Ⅱ水平比较差异无统计学意义(P>0.05)。Pearson分析显示,AFP与PIVKA-Ⅱ表达无明显相关性(P>0.05)。ROC曲线分析显示,AFP、PIVKA-Ⅱ对AFP阳性组近期疗效具有显著的评估价值(AUC=0.696、0.814,P<0.05);AFP对AFP阴性组近期疗效无显著的评估价值(P>0.05),但PIVKA-Ⅱ对AFP阴性组近期疗效具有较高的评估价值(AUC=0.724,P<0.05)。结论 AFP阴性HCC患者血清PIVKA-Ⅱ表达水平与AFP阳性HCC患者无明显差异,但可作为AFP阴性HCC患者近期疗效评价的有效指标。

Objective To explore the application value of protein induced by vitamin K antagonist-Ⅱ(PIVKA-Ⅱ) in patients with alpha fetoprotein(AFP) negative hepatocellular carcinoma(HCC). Methods 120 patients with hepatocellular carcinoma in our hospital from Jan 2019 to Jun 2021 were selected as the research objects.The serum levels of AFP and PIVKA-Ⅱ were detected in all patients, and all patients received TACE. According to the level of AFP, the patients were divided into AFP negative group and AFP positive group. The basic clinical characteristics and the levels of AFP and PIVKA-Ⅱ before and after treatment were compared between the two groups. Pearson test was used to analyze the correlation between the expression of AFP and PIVKA-Ⅱ. The receiver operating characteristic curve(ROC) was drawn and the area under the curve(AUC) was calculated to evaluate the value of AFP and PIVKA-Ⅱ for short-term efficacy. Results There was no significant difference in age, gender,Child-Pugh grade, BCLC stage, degree of differentiation, tumor size, tumor number and PIVKA-Ⅱ level between the two groups(P>0.05). After treatment, AFP Level in AFP positive group was significanty higher than that in AFP negative group(P<0.05), but there was no significant difference in PIVKA-Ⅱ level between the two groups(P>0.05).Pearson test showed that there was no significant correlation between AFP and PIVKA-Ⅱ expression(P>0.05). ROC curve analysis showed that AFP and PIVKA-Ⅱ had significant value for the evaluation of short-term efficacy in AFP positive group(AUC=0.696, 0.814, P<0.05). AFP had no significant value for the evaluation of short-term efficacy in AFP negative group(P>0.05), but PIVKA-Ⅱ had significant value for the evaluation of short-term efficacy in AFP negative group(AUC=0.724, P<0.05). Conclusion There was no significant difference in the expression of PIVKA-Ⅱbetween AFP negative and AFP positive HCC patients. It can be used as an effective index for the evaluation of short-term efficacy of AFP negative HCC.