PLT、PIVKA-Ⅱ、ALB联合检测在AFP阴性肝细胞癌和肝硬化中的鉴别诊断价值

The value of combined detection of PLT,PIVKA-Ⅱand ALB in the differential diagnosis of AFP-negative hepatocellular carcinoma and cirrhosis

目的探讨异常凝血酶原(PIVKA-Ⅱ)、血小板计数(PLT)、清蛋白(ALB)联合检测在甲胎蛋白阴性肝细胞癌(AFP-NHCC)和肝硬化(LC)中的鉴别诊断价值。方法选取2021年1月至2023年3月在广西医科大学第一附属医院住院治疗的69例AFP-NHCC患者作为AFP-NHCC组,另选取同期52例LC患者作为LC组,检测两组PLT、PIVKA-Ⅱ、ALB水平,并绘制受试者工作特征(ROC)曲线分析3项指标在AFP-NHCC和LC中的鉴别诊断价值。结果AFP-NHCC组PLT、PIVKA-Ⅱ、ALB水平均明显高于LC组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,PLT、PIVKA-Ⅱ、ALB单独检测鉴别诊断AFP-NHCC和LC的曲线下面积(AUC)分别为0.758、0.879、0.941,3项指标联合检测鉴别诊断AFP-NHCC和LC的灵敏度为91.3%,特异度为94.2%,AUC为0.977。结论PLT、PIVKA-Ⅱ、ALB联合检测可以弥补单独检测的劣势,可提高对AFP-NHCC与LC之间的鉴别诊断价值,具有重要的临床应用价值。

Objective To investigate the value of combined detection of abnormal prothrombin induced by abnormal prothrombin(PIVKA-Ⅱ),platelet count(PLT)and albumin(ALB)in the differential diagnosis of alpha-fetoprotein-negative hepatocellular carcinoma(AFP-NHCC)and liver cirrhosis(LC).Methods A total of 69 AFP-NHCC patients hospitalized in the First Affiliated Hospital of Guangxi Medical University from January 2021 to March 2023 were selected as the AFP-NHCC group,and 52 LC patients during the same period were selected as the LC group.The levels of PLT,PIVKA-Ⅱand ALB in the two groups were detected.Receiver operating characteristic(ROC)curve was drawn to analyze the differential diagnostic value of three parameters in AFP-NHCC and LC.Results The levels of PLT,PIVKA-Ⅱand ALB in AFP-NHCC group were significantly higher than those in LC group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of PLT,PIVKA-Ⅱand ALB in the differential diagnosis of AFP-NHCC and LC were 0.758,0.879 and 0.941 respectively.The sensitivity of combined detection of three indicators in the differential diagnosis of AFP-NHCC and LC was 91.3%,the specificity was 94.2%,and the AUC was 0.977.Conclusion Combined detection of PLT,PIVKA-Ⅱand ALB can make up for the disadvantages of individual detection and improve the differential diagnosis value between AFP-NHCC and LC,which has important clinical application value.