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目的探讨胰蛋白酶原-2(Try-2)对肝细胞癌(HCC)的诊断价值。方法选取2012年6—12月北京军区总医院全军肝病治疗中心明确诊断为HCC 34例,乙型肝炎肝硬化30例,慢性乙型肝炎30例,采用酶联免疫吸附试验(ELISA)检测血清Try-2及甲胎蛋白(AFP)的含量,并绘制血清Try-2在鉴别HCC和慢性乙型肝炎、HCC和乙型肝炎肝硬化的ROC曲线,探讨血清Try-2最佳临界值。结果 3种疾病血清Try-2含量比较差异有统计学意义(P<0.05)。当血清Try-2最佳临界值为7.30μg/L时,鉴别HCC和慢性乙型肝炎的灵敏度和特异度分别为89.11%和81.32%,Try-2 ROC曲线下面积小于AFP(P>0.05)。当血清Try-2最佳临界值为8.18μg/L时,鉴别HCC和乙型肝炎肝硬化的灵敏度和特异度分别为85.30%和63.32%,Try-2 ROC曲线下面积小于AFP(P<0.05)。结论血清Try-2能够用于临床筛查HCC,但其诊断效率劣于AFP。
Objective To investigate the diagnostic value of try-2 on hepatocellular carcinoma (HCC). Methods From June to December 2012, 34 cases of HCC, 30 cases of hepatitis B cirrhosis and 30 cases of chronic hepatitis B were diagnosed in the whole army liver disease treatment center of Beijing Military Region General Hospital. Serum was detected by enzyme-linked immunosorbent assay (ELISA) Try-2 and AFP levels were determined. The ROC curve of serum Try-2 in distinguishing HCC from cirrhosis of chronic hepatitis B, HCC and hepatitis B was drawn to explore the best cutoff value of serum Try-2. Results There were significant differences in Try-2 levels in the three diseases (P <0.05). The sensitivity and specificity of discriminating HCC from chronic hepatitis B were 89.11% and 81.32% respectively when the optimal cutoff value of Try-2 was 7.30μg / L, and the area under the curve of Try-2 ROC was less than that of AFP (P> 0.05) . The sensitivity and specificity of discriminating HCC from hepatitis B cirrhosis were 85.30% and 63.32% respectively when the optimal cutoff value of Try-2 was 8.18μg / L, and the area under the curve of Try-2 ROC was less than that of AFP (P <0.05 ). Conclusion Serum Try-2 can be used in clinical screening of HCC, but its diagnostic efficiency is lower than that of AFP.