肝癌三联检在原发性肝癌患者中的诊断效果及与肝脏纤维化指标的相关性

Diagnostic effect of liver cancer triple test in patients with primary liver cancer and its correlation with liver fibrosis indicators

目的探讨肝癌三联检在原发性肝癌(PLC)患者中的诊断效果及与肝脏纤维化指标的相关性。方法选取2019年1月至2022年1月福建医科大学附属泉州第一医院收治的PLC患者120例为PLC组,选取同期慢性肝炎或者肝硬化患者120例为良性肝病组,选取经过全面体检或者B超检查各项指标均正常的120例体检者为健康组。检测各组血清甲胎蛋白(AFP)、甲胎蛋白异质比率(AFP-L3%)、血清异常凝血酶原(PIVKAⅡ)与肝纤维化指标的相关性;通过ROC曲线分析AFP、AFP-L3%、PIVKAⅡ及三者联合的诊断效能。结果三组血清AFP、AFP-L3%、PIVKAⅡ水平比较,差异有统计学意义(P<0.05);三组肝纤维化指标比较,差异有统计学意义(P<0.05);透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原肽(PCⅢ)、Ⅳ型胶原蛋白(Ⅳ-C)与AFP、AFP-L3%、PIVKAⅡ水平呈正相关(P<0.05);血清联合诊断效能高于AFP、AFP-L3%、PIVKAⅡ单独检测,差异有统计学意义(P<0.05)。结论肝癌三联检在PLC患者诊断中具有较高的诊断效果,且反映出肝纤维化程度,在临床中具有一定的价值。

Objective To explore the diagnostic efficacy of liver cancer triple test in patients with primary liver cancer(PLC)and its correlation with liver fibrosis indicators.Methods The research subjects selected 120 patients with PLC admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from January 2019 to January 2022 as the PLC group,120 patients with chronic hepatitis or cirrhosis during the same period as the benign liver disease group,and 120 patients who underwent comprehensive physical examination or B-ultrasound examination with normal indicators as the health group.The levels of serum alpha fetoprotein(AFP),alpha fetoprotein heterogeneity ratio(AFP L3%),serum abnormal prothrombin(PIVKA-Ⅱ),and liver fibrosis indicators in each group,as well as their correlation were detected,the diagnostic efficacy of AFP,AFP L3%,PIVKA-Ⅱ,and their combination through the ROC curve were analyzed.Results The comparison of serum AFP,AFP-L3%,and PIVKAⅡlevels among the three groups showed statistically significant differences(P<0.05).The difference in liver fibrosis indicators among the three groups was statistically significant(P<0.05).Hyaluronic acid(HA),laminin(LN),typeⅢprocollagen peptide(PCⅢ),and typeⅣcollagen(Ⅳ-C)were positively correlated with levels of AFP,AFP-L3%,and PIVKAⅡ(P<0.05).The combined diagnostic efficacy of serum was higher than that of AFP,AFP-L3%,and PIVKAⅡalone,with statistically significant differences(P<0.05).Conclusion The triple test for liver cancer has a high diagnostic effect in PLC patients and reflects the degree of liver fibrosis,which has certain clinical value.