AFP-L3、CEA、CA153在乙肝相关肝癌中的诊断分析

Diagnostic Analysis of AFP L3,CEA,CA153 in Hepatitis B Related Liver Cancer

目的:探讨甲胎蛋白异质体(AFP-L3)、癌胚抗原(CEA)与糖类抗原153(CA153)在乙肝相关肝癌中的诊断价值。方法:选取2021年6月—2022年6月湖北江汉油田总医院收治的60例乙肝相关肝癌患者作为A组,同时纳入同期收治的56例肝硬化患者以及50例健康体检者分别作为B组和C组。3组均接受血清AFP-L3、CEA、CA153水平测定,对比三组血清AFP-L3、CEA、CA153水平差异,运用受试者曲线(ROC)分析AFP-L3、CEA、CA153在乙肝相关肝癌中的诊断价值。结果:3组血清AFP-L3、CEA、CA153水平为A组>B组>C组。ROC曲线分析显示,AFP-L3、CEA、CA153联合诊断乙肝相关肝癌的曲线下面积(AUC)为0.865,相较于各项指标单独检测明显更高,且联合检测敏感度相对各项指标单独检测更高。三者诊断乙肝相关性肝癌的敏感度分别为70.00%、75.00%、71.67%,特异度分别为84.00%、78.00%、86.00%,最佳截断值分别为10.05%、9.77 U/L、40.23 IU/mL。结论:AFP-L3、CEA、CA153在乙肝相关肝癌患者中表达水平较高,对于乙肝相关肝癌具有较高的诊断价值,且其联合应用诊断价值更高。

Objective:To explore the diagnostic value of alpha fetoprotein heterogeneity(AFP-L3),carcinoembryonic antigen(CEA)and carbohydrate antigen 153(CA153)in hepatitis B related liver cancer.Methods:60 patients with hepatitis B related liver cancer from June 2021 to June 2022 were treated as group A.56 patients with liver cirrhosis and 50 patients with physical examination at the same time were treated as group B and group C respectively.All patients in the three groups received the determination of serum AFP-L3,CEA and CA153 levels.The differences of serum AFP-L3,CEA and CA153 levels in the three groups were compared.The diagnostic value of AFP-L3,CEA and CA153 in hepatitis B related liver cancer was analyzed by receiver operating characteristic analysis(ROC).Results:The levels of serum AFP-L3,CEA and CA153 in the three groups were group A>group B>group C(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the combined diagnosis of AFP-L3,CEA and CA153 for hepatitis B related liver cancer was 0.865,which was significantly higher than that of the independent detection of various indicators.The combined detection sensitivity and specificity were higher than the independent detection of various indicators.The sensitivity of the three methods in diagnosing hepatitis B related liver cancer was 70.00%,75.00%and 71.67%respectively.The specificity was 84.00%,78.00%and 86.00%respectively.The best cutoff values were 10.05%,9.97 U/L and 40.23 IU/mL,respectively.Conclusion:The expression level of AFP-L3,CEA and CA153 in patients with hepatitis B-related liver cancer is high,which has higher diagnostic value for hepatitis B-related liver cancer.