血清壳多糖酶3样蛋白1、甲胎蛋白、糖类抗原19-9及谷氨酰转肽酶在原发性肝癌早期诊断中的应用价值

Application value of chitosanase 3-like protein 1, alpha-fetoprotein, glycoactrin 19-9, glutamyltranspeptidase in the early diagnosis of primary liver cancer

目的 探讨血清壳多糖酶3样蛋白1(CHI3L1)、甲胎蛋白(AFP)、糖类抗原19-9(CA19-9)和谷氨酰转肽酶(GGT)单一及联合检测在原发性肝癌早期诊断中的临床应用价值。方法 选取原发性肝癌患者19例,肝硬化患者20例,慢性乙型肝炎患者31例以及健康体检者30例作为研究对象,采用磁微粒化学发光法检测血清中CHI3L1的水平,化学发光法检测血清AFP及CA19-9水平,速率法检测血清中GGT的水平。采用非参数秩和检验进行差异分析,通过ROC曲线下面积分析,比较单项及联合检测的诊断价值。结果 单项指标检测中,CHI3L1的AUC最大,为0.848,灵敏度最高,为89.5%,AFP的特异度最高,为95.1%;多指标联合检测时,CHI3L1+AFP和CHI3L1+AFP+CA19-9的AUC最大,均为0.884,高于各指标单项检测的AUC,CHI3L1+AFP、CHI3L1+AFP+CA19-9、CHI3L1+AFP+GGT和4项指标联合检测时灵敏度最高,为94.7%。结论 CHI3L1在原发性肝癌早期诊断方面有较大的价值,CHI3L1、AFP、CA19-9及GGT联合诊断能提高诊断效能。

Objective This paper aims to investigate the clinical value of single and combined detection of serum chitosanase 3-like protein 1(CHI3L1), alpha-fetoprotein(AFP), carbohydrate antigen19-9(CA19-9) and glutamyltranspeptidase(GGT) in the early diagnosis of primary liver cancer. Methods A total of 19 patients with primary liver cancer, 20 patients with cirrhosis, 31 patients with chronic hepatitis B and 30 cases of healthy examinees were selected as research objects, and the serum level of CHI3L1 was detected by magnetic particle chemiluminescence, the serum levels of AFP and CA19-9 were detected by chemiluminescence, and the level of GGT in serum was detected by rate method. Difference analysis was performed using nonparametric rank and tests, and the diagnostic value of single and combined tests was compared by area analysis under the ROC curve. Results Among the single index detection, the AUC of CHI3L1 was the largest(0.848), the sensitivity was highest(89.5%), and the specificity of AFP was the highest(95.1%);in the combined detection of multiple indicators, the AUC of CHI3L1+AFP and CHI3L1+AFP+CA19-9 was the largest, and both of which were 0.884, which was higher than that of any single index;the sensitivity of CHI3L1+AFP, CHI3L1+AFP+CA19-9, CHI3L1+AFP+GGT and the combined detection of four indicators were the highest(94.7%). Conclusion CHI3L1 has great value in the early diagnosis of primary liver cancer, and the combined diagnosis of CHI3L1, AFP, CA19-9 and GGT can improve the diagnostic efficiency.