高光剑,潘耀振
GAO Guangjian,PAN Yaozhen

• 1:贵州医科大学

摘要(Abstract)：

目的:了解异常凝血酶原(PIVKA-Ⅱ)、甲胎蛋白(AFP)对原发性肝癌(PHC)的诊断价值。方法:选择88例PHC患者(PHC组)、9例肝硬化患者(肝硬化组)及76例非肝病患者(对照组)作为研究对象,通过电化学发光法和化学发光法对各组被检者血清PIVKA-Ⅱ、AFP水平进行检测,且PHC组患者行上腹部增强CT,比较各组被检者血清PIVKA-Ⅱ、AFP水平及阳性率,计算血清PIVKA-Ⅱ、AFP单独或联合使用对PHC的诊断效能,比较不同肿瘤大小PHC患者血清PIVKA-Ⅱ、AFP水平及阳性率,观察治疗前后血清PIVKA-Ⅱ、AFP水平及肿瘤大小变化。结果:PHC组血清PIVKA-Ⅱ、AFP水平及阳性率均高于肝硬化组和对照组,差异有统计学意义(P<0.05);血清PIVKA-Ⅱ、AFP单独使用对诊断PHC有较高的灵敏度、特异度和准确度,联合使用能提高诊断的特异度;肿瘤病灶>50 mm的PHC患者血清PIVKA-Ⅱ、AFP水平高于肿瘤病灶≤50 mm患者,差异有统计学意义(P<0.05);治疗后PHC组患者血清PIVKA-Ⅱ、AFP水平较治疗前明显下降,且肿瘤变小,差异有统计学意义(P<0.05)。结论:PIVKA-Ⅱ联合AFP对提高PHC的早期诊断符合率有一定帮助。
Objective:To investigate the diagnostic value of PIVKA-Ⅱ and AFP on primary hepatic carcinoma determination.Methods:88 PHC patients as PHC group,9 liver cirrhosis patients as liver cirrhosis group,and 76 non-liver disease patients as control group;the serum PIVKA-Ⅱ and AFP level in all groups were detect by electrochemiluminescence and chemiluminescence.PHC group received upper abdominal enhanced CT scanning.Serum PIVKA-Ⅱ and AFP level and positive rate were compared;calculating diagnostic performance of single or combined PIVKA-Ⅱ and AFP on PHC;comparing the serum PIVKA-Ⅱ and AFP level and positive rate of PHC patients with different tumor size,and observing serum PIVKA-Ⅱ and AFP level and tumor size change before and after treatment.Results:The level and positive rate of serum PIVKA-Ⅱ and AFP in PHC group were higher than Cirrhosis group and Control group,differences were statistically significant(P<0.05).The independence of PIVKA-Ⅱ or AFP showed high sensitivity,specificity and accuracy on diagnosing PHC.However,combined use can improve the diagnosis specificity.The serum level of PIVKA-Ⅱ and AFP of PHC patients with tumor lesion>50 mm was higher than that of ≤50 mm,differences were statistically significant(P<0.05).After treatment,serum level of PIVKA-Ⅱ and AFP of PHC patients obviously lowered compared with before treatment,and tumor size was reduced,differences were statistically significant(P<0.05).Conclusion:Combined PIVKA-Ⅱ and AFP can be helpful for improving the early diagnosis coincidence rate of PHC.

关键词(KeyWords)： 原发性肝癌;肝硬化;异常凝血酶原;甲胎蛋白;诊断
primary hepatic carcinoma;liver cirrhosis;abnormal prothrombin;alfa-fetoprotein;diagnosis

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 高光剑,潘耀振
GAO Guangjian,PAN Yaozhen

DOI: 10.19367/j.cnki.1000-2707.2019.01.020

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