血清生物学标志物联合检测对原发性肝癌的诊断效能

Diagnostic efficacy of combined detection of serum biomarkers for primary liver cancer

目的分析血清生物学标志物联合检测对原发性肝癌的诊断价值。方法选择2020年6月—2022年6月在启东市人民医院接受检查的60例原发性肝癌患者作为研究对象,纳入肝癌组;另外选择60例普通肝病患者纳入肝病组。采用化学发光法对所有入组者进行血清甲胎蛋白(AFP)检测,采用酶联免疫吸附试验(ELISA)检测异常凝血酶原(DCP)和磷脂酰肌醇蛋白聚糖3(GPC3)水平;比较肝癌组和肝病组以及不同分期肝癌患者上述指标水平差异;绘制受试者工作特征(ROC)曲线并计算ROC曲线下面积(AUC),分析各指标单独与联合检测对原发性肝癌的诊断效能。结果肝癌组的AFP、DCP和GPC3水平均明显高于肝病组[AFP(μg/L):155.21±44.78比90.12±23.44,DCP(μg/L):216.23±60.42比114.17±33.79,GPC3(μg/L):189.79±48.44比94.72±22.18,均P<0.05]。Ⅲ~Ⅳ期肝癌患者的AFP、DCP和GPC3水平均明显高于Ⅰ~Ⅱ期患者[AFP(μg/L):206.72±50.16比132.21±32.44,DCP(μg/L):248.12±70.68比164.21±52.65,GPC3(μg/L):243.56±50.28比122.32±35.54,均P<0.05]。AFP、DCP与GPC3联合检测诊断原发性肝癌的AUC为0.992[95%可信区间(95%CI)为0.954~1.000],敏感度和特异度分别为91.67%和100.00%,均高于各指标单独检测。结论原发性肝癌患者血清AFP、DCP和GPC3水平异常上升,联合检测各项指标可准确诊断疾病并评估疾病严重程度,存在推广价值。

Objective To analyze the diagnostic value of combined detection of serum biomarkers in primary liver cancer.Methods Sixty patients with primary liver cancer who underwent examinations at Qidong People's Hospital from June 2020 to June 2022 were selected as research objects and included in liver cancer group,and other 60 patients with common liver diseases were included in liver disease group.The level of serum alpha fetoprotein(AFP)was detected by chemiluminescence method,and the levels of DES-γ-carboxyl prothrombin(DCP)and glypican-3(GPC3)were detected by enzyme linked immunosorbent assay(ELISA).The differences of above indicators between liver cancer group and liver disease group,and different stages of liver cancer patients were compared.The receiver operator characteristic(ROC)curve was drawn and the area under ROC curve(AUC)was calculated to analyze the diagnostic efficacy of each indicator alone and in combination.Results The levels of AFP,DCP and GPC3 in liver cancer group were significantly higher than those in liver disease group[AFP(μg/L):155.21±44.78 vs.90.12±23.44,DCP(μg/L):216.23±60.42 vs.114.17±33.79,GPC3(μg/L):189.79±48.44 vs.94.72±22.18,all P<0.05].The levels of AFP,DCP and GPC3 in patients with stageⅢ-Ⅳliver cancer were significantly higher than those in patients with stageⅠ-Ⅱliver cancer[AFP(μg/L):206.72±50.16 vs.132.21±32.44,DCP(μg/L):248.12±70.68 vs.164.21±52.65,GPC3(μg/L):243.56±50.28 vs.122.32±35.54,all P<0.05].The combined detection of AFP,DCP and GPC3 for the diagnosis of primary liver cancer had an AUC of 0.992[95%confidence interval(95%CI)was 0.954-1.000],the sensitivity and specificity were 91.67%and 100.00%,respectively,which were higher than those detected separately for each indicator.Conclusions The levels of AFP,DCP and GPC3 in serum of patients with primary liver cancer are abnormally elevated.The combined detection of various indicators could not only accurately diagnose the disease,but also evaluate the severity of the disease,which is of popularization value.