血清AFP、GP73及PIVKA-Ⅱ检测对原发性肝癌的诊断效能

Diagnostic Efficacy of Serum AFP,GP73 and PIVKA-Ⅱin Primary Liver Cancer

目的研究血清甲胎蛋白(AFP)、高尔基体73(GP73)及异常凝血酶原(PIVKA-Ⅱ)单独及联合检测对原发性肝癌的诊断效能。方法选取2021年1月-12月我院检验中心确诊的原发性肝癌患者132例作为原发性肝癌组,将肝炎、肝纤维化、肝硬化患者92例作为良性对照组,99名体检健康者作为健康对照组。采用磁微粒化学免疫发光法分析三组受试者血清AFP、GP73及PIVKA-Ⅱ水平,并比较各组差异。用受试者ROC工作曲线分析AFP、GP73及PIVKAⅡ对原发性肝癌的诊断价值。结果原发性肝癌组血清AFP、GP73、PIVKA-Ⅱ水平均高于良性对照组和健康对照组(P<0.05);血清AFP、GP73、PIVKA-Ⅱ对原发性肝癌检测特异性分别为96.93%、70.72%、93.22%,敏感性分别为51.90%、81.51%、75.91%,AUC分别为0.77、0.80、0.88,血清PIVKA-Ⅱ具有高敏感性、特异性及AUC;三者联合诊断原发性肝癌的特异性为88.89%,敏感性为83.24%,AUC为0.90,均高于单一检测(P<0.05)。结论AFP、GP73、PIVKA-Ⅱ三者联合检测可提高原发性肝癌的检出率,降低漏诊率。

Objective To study the diagnostic efficacy of single and combined detection of serum alpha-fetoprotein(AFP),Golgi 73(GP73)and abnormal prothrombin(PIVKA-Ⅱ)in primary liver cancer.Methods A total of 132 patients with primary liver cancer diagnosed in our hospital from January to December 2021 were selected as the primary liver cancer group,92 patients with hepatitis,liver fibrosis and cirrhosis were selected as the benign control group,and 99 healthy subjects were selected as the healthy control group.The levels of serum AFP,GP73 and PIVKA-Ⅱin the three groups were analyzed by magnetic particle chemical immunoluminescence method,and the differences between the groups were compared.The diagnostic value of AFP,GP73 and PIVKA-Ⅱin primary liver cancer was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum AFP,GP73 and PIVKA-Ⅱin primary liver cancer group were higher than those in benign control group and healthy control group(P<0.05).The specificity of serum AFP,GP73 and PIVKA-Ⅱin the detection of primary liver cancer was 96.93%,70.72%and 93.22%,respectively;the sensitivity was 51.90%,81.51%and 75.91%,respectively;the AUC was 0.77,0.80 and 0.88,respectively,thus serum PIVKA-Ⅱhad high sensitivity,specificity and AUC.The specificity,sensitivity and AUC of the combined diagnosis of primary liver cancer were 88.89%,83.24%and 0.90,respectively,which were higher than those of single detection(P<0.05).Conclusion The combined detection of AFP,GP73 and PIVKA-Ⅱcan improve the detection rate of primary liver cancer and reduce the rate of missed diagnosis.