血清异常凝血酶原检测对原发性肝癌诊断的临床价值

袁丽仙; 张洪涛; 李锐; 陈昆锐; 陈坤前; 徐安书

doi:10.12259/j.issn.2095-610X.S20201223

血清异常凝血酶原检测对原发性肝癌诊断的临床价值

doi: 10.12259/j.issn.2095-610X.S20201223

1.
昆明医科大学附属曲靖医院核医学科
2.
医务部
3.
感染科
4.
心脏血管外科
5.
普外科，云南曲靖　655000

基金项目: 白求恩医学研究基金资助项目（BY201603-04）

详细信息

作者简介:
袁丽仙（1981～），女，云南富源人，医学硕士，主治医师，主要从事内分泌激素及肿瘤标志物的研究工作

通讯作者:
张洪涛，E-mail： 1574505986@qq.com

中图分类号: R735.7
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- 被引次数: 0
出版历程
- 收稿日期: 2020-04-16
- 刊出日期: 2019-12-26

Diagnostic Efficacy of Serum PIVKA-Ⅱ Detection in Primary Hepatocellular Carcinoma

1.
Dept. of Nuclear Medicine
2.
Dept. of the Medical Affairs
3.
Dept. of Infectious Diseases
4.
Dept. of Cardiovascular Surgery
5.
Dept. of General Surgery, Qujing Affiliated Hospital of Kunming Medical University, Qujing Yunnan 655000, China

摘要

摘要: 目的分析血清异常凝血酶原（protein induced by vitamin K absence or antagonist-Ⅱ，PIVKA-Ⅱ）对原发性肝癌诊断的临床价值及意义。方法选取昆明医科大学附属曲靖医院诊治的150例患者，分为慢性乙型肝炎组50例，慢性丙型肝炎组50例，原发性肝癌组50例，同期选取50例健康体检者作为正常对照组。分别采用日本LUMIPULSE G1200全自动免疫分析仪检测血清PIVKA-Ⅱ浓度，德国罗氏Cobas e601全自动电化学发光免疫分析仪检测血清甲胎蛋白（alpha fetoprotein，AFP）浓度。结果原发性肝癌组血清PIVKA-Ⅱ和AFP浓度均明显高于慢性肝病组和正常对照组（P < 0.05）。PIVKA-Ⅱ诊断原发性肝癌的敏感性为94.0%，特异性为95.3%；AFP诊断原发性肝癌的敏感性为76.0%，特异性为90.0%。受试者工作特征曲线（ROC）分析结果显示，PIVKA-Ⅱ和AFP诊断原发性肝癌的曲线下面积分别为0.963和0.848。结论血清PIVKA-Ⅱ诊断原发性肝癌的临床价值优于AFP，值得临床研究推广。
- 肝细胞癌 /
- 慢性乙型肝炎 /
- 慢性丙型肝炎 /
- 异常凝血酶原 /
- 甲胎蛋白
Abstract: Objective To explore the diagnostic efficacy of serum Protein induced by vitamin K absence or antagonist-Ⅱ（PIVKA-Ⅱ）in Primary hepatocellular carcinoma. Methods 150 patients who diagnosed and treated in Qujing Affiliated Hospital of Kunming Medical University were divided into chronic hepatitis B group（HBV, n = 50）, chronic hepatitis C group（HCV, n = 50）and Hepatocellular carcinoma group（HCC, n = 50）, and 50 healthy people were selected as normal control group. Serum PIVKA-Ⅱ concentration were detected by Fujirebio-Lumipulse G1200 system and alpha fetoprotein（AFP）concentration were detected by Roche Cobas e601 immunoassay system. Results The serum PIVKA-Ⅱ and AFP concentrations in HCC group were significantly higher than those in chronic liver disease groups and normal control group（P < 0.05）. The sensitivity and specificity of PIVKA-Ⅱ in the diagnosis of HCC were 94.0% and 95.3%, compared with AFP’ s 76.0% and 90.0% for specificity, respectively. Subjects operating characteristic curve（ROC）showed that the areas under curve of PIVKA-Ⅱ and AFP were 0.963 and 0.848, respectively. Conclusions The diagnostic efficacy of Serum PIVKA-Ⅱ is better than AFP in diagnosing Primary Hepatocellular Carcinoma and can be used in clinical practice.
- Hepatocellular carcinoma /
- Chronic hepatitis B /
- Chronic hepatitis C /
- Protein induced by vitamin K absence or antagonist-Ⅱ /
- Alpha-fetoprotein

HTML全文

图 1 血清PIVKA-Ⅱ和AFP诊断HCC的ROC曲线

Figure 1. The ROC curve of serum PIVKA-Ⅱ and AFP in the Diagnosis of HCC

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图 2 良恶性肝病血清PIVKA-Ⅱ和AFP浓度相关分析

Figure 2. Correlation analysis of serum PIVKA - Ⅱ and AFP in benign and malignant liver diseases

下载: 全尺寸图片幻灯片

表 1 四组血清PIVKA-Ⅱ、AFP、γ-GT和ALP结果比较[M（P₂₅，P₇₅）]

Table 1. Comparison of serum PIVKA-Ⅱ、AFP、γ-GT and ALP of four groups[M（P₂₅，P₇₅）]

组别	例数（n）	PIVKA-Ⅱ/（mAU/mL）	AFP/（ng/mL）	γ-GT/（U/L）	ALP/（U/L）
正常组	50	22.00（20.00，24.25）*	3.27（2.29，4.27）*	31.00（21.50，41.00）*	69.00（57.25，79.00）*
HBV组	50	23.00（17.75，26.00）*	2.97（2.16，5.38）*	25.00（15.75，47.00）*	75.00（55.75，93.00）*
HCV组	50	24.00（20.00，28.00）*	4.29（2.99，7.99）*	45.00（21.75，119.75）*^#	82.50（66.00，98.25）*
HCC组	50	3360.0（536.75，11586.25）	108.3（9.40，1210.00）	124.00（49.50，244.75）	111.00（72.50，183.00）
χ²		98.92	64.96	61.58	32.53
P		< 0.001	< 0.001	< 0.001	< 0.001
注：与HCC组相比，^*P < 0.05；与正常组相比， ^# P < 0.05。

下载: 导出CSV

表 2 血清PIVKA-Ⅱ和AFP诊断HCC的灵敏度及特异性（%）

Table 2. The sensitivity and specificity of serum PIVKA-Ⅱ and AFP in diagnosing of HCC（%）

检测项目	灵敏度	特异度
PIVKA-Ⅱ	94.0	95.3
AFP	76.0	90.0

下载: 导出CSV

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