PIVKA-Ⅱ、AFU、NLR联合检测对甲胎蛋白阴性肝细胞癌的诊断价值

The Diagnostic Value of Combined Detection of PIVKA-Ⅱ,AFU,and NLR in the Diagnosis of Alpha-fetoprotein-negative Hepatocellular Carcinoma

目的 探讨新型肿瘤标志物异常凝血酶原(PIVKA-Ⅱ)、α-L-岩藻糖苷酶(AFU)、外周血中性粒细胞/淋巴细胞比值(NLR)联合检测在甲胎蛋白阴性的肝细胞癌(AFP-NHCC)诊断中的价值。方法 选取2021年1月至2023年12月在我院就诊的200例肝病患者,其中包括100例AFP-NHCC患者为观察组,100例肝良性病变患者为对照组。通过检测所有受试者的PIVKA-Ⅱ、AFU和NLR,比较两组之间的差异,计算ROC曲线下面积来判断各指标的诊断效能。结果 观察组中PIVKA-Ⅱ、AFU、NLR水平较对照组明显升高,差异有统计学意义(P<0.05)。3种指标中,PIVKA-Ⅱ诊断AFP-NHCC的效能最佳,AUC为0.790,灵敏度为57.0%,特异度为100%。3种指标联合检测诊断AFP-NHCC的AUC为0.868,灵敏度为66.0%,特异度为96.0%。结论 PIVKA-Ⅱ、AFU、NLR对AFP-NHCC患者有一定的诊断价值,三者联合检测可显著提高诊断效能,减少漏诊。

Objectives To investigate the value of combined detection of new tumor markers abnormal prothrombin(PIVKA-II),α-L-fucosidase(AFU) and peripheral blood neutrophil/lymphocyte ratio(NLR) in the diagnosis of alphafetoprotein-negative hepatocellular carcinoma(AFP-NHCC).Methods A total of 200 patients with liver disease treated in our hospital from January 2021 to December 2023 were selected as the study objects,including 100 patients with AFP-NHCC as the observation group and 100 patients with benign liver lesions as the control group.By detecting PIVKA-Ⅱ,AFU and NLR of all subjects,the differences between the two groups were compared,and the area under the ROC curve was calculated to judge the diagnostic efficacy of each index.Results The levels of PIVKA-Ⅱ,AFU and NLR in the observation group increased significantly compared with those in the control group(P<0.05).Among the three indicators,PIVKA-II had the best efficacy in the diagnosis of AFP-NHCC,with AUC of0.790,sensitivity of 57.0% and specificity of 100%.The AUC of the combined detection of the three indicatorsof AFP-NHCC was 0.868,the sensitivity was 66.0%,and the specificity was 96.0%.Conclusions PIVKA-Ⅱ,AFU and NLR have certain diagnostic value for AFP-NHCC patients,and the combined detection of the three can significantly improve the diagnostic efficiency and reduce missed diagnosis.