ALP、LDH联合AFP在原发性肝癌中的表达及诊断价值

Expression and diagnostic value of ALP,LDH combined with AFP in primary liver cancer

目的分析碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)联合甲胎蛋白(AFP)检测在原发性肝癌(PHC)的表达及诊断价值。方法收集2018年7月至2020年6月河南大学淮河医院收治的113例原发性肝癌患者(PHC组),以及同期行健康体检者100名为对照组,及同期乙型肝炎患者105例作为乙型肝炎组。对比不同人群中ALP、LDH、AFP表达水平。对比不同分级PHC患者中ALP、LDH、AFP表达水平。对比不同预后PHC患者中ALP、LDH、AFP表达水平。绘制受试者工作特征(ROC)曲线,评估不同诊断方式的诊断效能。结果ALP、LDH、AFP表达水平:PHC组>乙型肝炎组>对照组,差异有统计学意义(P<0.05);Ⅲ~Ⅳ级PHC患者ALP、LDH、AFP表达水平明显高于Ⅰ~Ⅱ级,差异有统计学意义(P<0.05);随访截止至2021年10月,113例患者中,预后不良34例,预后良好79例,预后不良者其ALP、LDH、AFP表达水平明显高于预后良好者,差异有统计学意义(P<0.05);ALP、LDH联合AFP检测对PHC的诊断灵敏度、特异度分别0.915、0.882,ALP、LDH、AFP联合MRI灵敏度、特异度分别0.976、0.915。结论ALP、LDH、AFP在PHC中均为高表达,与患者病情严重程度及预后有一定的联系,三者联合检测诊断效能较高,与MRI检查联合检测诊断效能更佳,可为临床早期诊断、治疗提供一定诊断线索和参考依据。

Objective To analyze the expression and diagnostic value of alkaline phosphatase(ALP),lactate dehydrogenase(LDH)combined with alpha⁃fetoprotein(AFP)detection in primary liver cancer(PHC).Methods A total of 113 patients with primary liver cancer admitted to Huaihe Hospital of Henan University from July 2018 to June 2020(PHC group),100 healthy subjects who underwent physical examination during the same period were selected as the control group,and 105 patients with benign liver disease during the same period were selected as the benign group.(1)The expression levels of ALP,LDH,and AFP in different populations were compared.(2)The expression levels of ALP,LDH,and AFP in PHC patients of different grades were compared.(3)The expression levels of ALP,LDH,and AFP in PHC patients with different prognosis were compared.(4)Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic effectiveness of different diagnostic methods.Results The expression levels of ALP,LDH and AFP were as follows:PHC group>benign group>control group,the difference was statistically significant(P<0.05).The expression levels of ALP,LDH,and AFP in patients with gradeⅢ~ⅣPHC were significantly higher than those in patients with gradeⅠ~Ⅱ,the difference was statistically significant(P<0.05).The follow⁃up ended in October 2021,among the 113 patients,34 had a poor prognosis and 79 had a good prognosis,the expression levels of ALP,LDH,and AFP in those with poor prognosis were significantly higher than those with good prognosis,the difference was statistically significant(P<0.05).The diagnostic sensitivity and specificity of ALP and LDH combined with AFP for PHC were 0.915 and 0.882,respectively;the diagnostic sensitivity and specificity of ALP,LDH and AFP combined with MRI were 0.976 and 0.915,respectively.Conclusion ALP,LDH and AFP are highly expressed in PHC,and have a certain relationship with the severity and prognosis of patients.The combined detection of the three has higher diagnostic efficacy,and the combined detection with MRI is better.It can provide certain diagnostic clues and references for early clinical diagnosis and treatment.