甲胎蛋白与甲胎蛋白异质体联合检测对肝癌的诊断效能及其与预后的相关性

Diagnostic efficacy of combined detection of alpha-fetoprotein and alpha-fetoprotein variant in liver cancer and correlations among their levels and prognosis

目的:探讨甲胎蛋白(AFP)与甲胎蛋白异质体(AFP-L3)联合检测对肝癌的诊断效能及其与预后的相关性。方法:回顾性分析2014年2月至2016年2月该院收治的117例肝癌患者、120例肝良性肿瘤患者的临床资料。比较良恶性肿瘤患者血清AFP、AFP-L3水平,绘制受试者工作特征(ROC)曲线并分析血清AFP、AFP-L3水平单项及联合检测在肝癌诊断中的效能,比较肝癌存活患者与死亡患者血清AFP、AFP-L3水平,并通过Pearson相关系数分析AFP、AFP-L3水平与肝癌预后的相关性。结果:肝癌患者血清AFP、AFP-L3水平均高于肝良性肿瘤患者,差异有统计学意义(P<0.05);ROC曲线显示,血清AFP、AFP-L3水平单项及联合检测诊断肝癌的曲线下面积依次为0.712、0.726、0.874,联合检测诊断效能最高;肝癌死亡患者血清AFP、AFP-L3水平均高于存活患者,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,血清AFP、AFP-L3水平与肝癌患者死亡率均呈正相关(r>0,P<0.05)。结论:血清AFP联合AFP-L3水平检测在肝癌诊断中的效能高于两者单项检测,且两者水平与肝癌死亡率呈正相关。

Objective:To investigate diagnostic efficacy of combined detection of alpha-fetoprotein(AFP)and alpha-fetoprotein variant(AFP-L3)in liver cancer and correlations among their levels and prognosis.Methods:The clinical data of 117 patients with liver cancer admitted to this hospital from February 2014 to February 2016 were retrospectively analyzed,and they were set as liver cancer group.The clinical data of 120 patients with benign liver tumors admitted to the hospital during the same period were analyzed,and they were included in benign liver tumor group.The serum AFP and AFP-L3 levels were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn and the efficacies of single and combined detection of serum AFP and AFP-L3 levels in the diagnosis of liver cancer were analyzed.The serum AFP and AFP-L3 levels were compared between the survival patients and the death patients in the liver cancer group.Further,Pearson correlation coefficient was used to analyze correlations among the AFP and AFP-L3 levels and prognosis.Results:The levels of serum AFP and AFP-L3 in the liver cancer group were higher than those in the benign liver tumor group,and the differences were statistically significant(P<0.05).The ROC curve showed that the AUCs of single and combined detection of serum AFP and AFP-L3 levels in the diagnosis of liver cancer were 0.712,0.726 and 0.874,separately,and the diagnostic efficiency of combined detection was the highest.The levels of serum AFP and AFP-L3 in the dead patients in the liver cancer group were higher than those in the survival patients,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum AFP and AFP-L3 levels were positively correlated with the death in the patients with liver cancer(r=0.681,0.633,P<0.05).Conclusions:The efficacy of the combined detection of serum AFP and AFP-L3 levels in the diagnosis of liver cancer is higher than that of single detection,and the levels of both are positively correlated with the death of liver cancer.