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目的探讨血浆长链非编码RNA印迹母系表达转录体(H19)在原发性肝癌(primary hepatic carcinoma,PHC)中的临床诊断意义。方法收集并检测180例PHC患者和211例非肝癌患者血浆中H19、甲胎蛋白(AFP)、γ-谷氨酰基转氨酶2(γ-GT2)、异常凝血酶原(AP)、α-L-岩藻糖苷酶(AFU)和碱性磷酸酶-1(ALP-1)的表达水平,Logistic回归和受试者工作(ROC)曲线分析其特异性、灵敏度等指标。结果 H19在PHC患者血浆中的表达水平明显升高,差异有统计学意义(P<0.01);H19的AUC值为0.868,约登指数为0.702,H19相对表达水平临界阈值设定为0.073时,诊断灵敏度为77.78%,特异度为92.42%;H19+AFP的AUC为0.949,灵敏度为86.11%,特异度为92.42%,约登指数为0.753,其约登指数最高;H19+AFP+γ-GT2联合检测时,AUC可达0.961,灵敏度为91.67%,特异度为91.00%,约登指数为0.827。结论 H19在PHC患者中表达水平明显升高并可作为PHC临床诊断的独立标志物;H19+AFP+γ-GT2联合检测具有较好的诊断效能。
Objective To investigate the significance of plasma long-term non-coding Northern blot transcript (H19) expression in primary hepatic carcinoma (PHC). Methods Plasma levels of H19, AFP, γ-GT2, AP, α-L-asparaginase in 180 PHC patients and 211 non-HCC patients were collected and tested. (AFU) and alkaline phosphatase-1 (ALP-1), Logistic regression and receiver operating characteristic (ROC) curves were used to analyze the specificity, sensitivity and other indicators. Results The plasma level of H19 was significantly increased in PHC patients (P <0.01). The AUC of H19 was 0.868, the Youden index was 0.702, and the critical threshold of H19 relative expression level was 0.073. The diagnostic sensitivity was 77.78% and the specificity was 92.42%. The AUC of H19 + AFP was 0.949, the sensitivity was 86.11%, the specificity was 92.42%, the Youden index was 0.753, and the Yoden index was the highest. H19 + AFP + γ-GT2 AUC was 0.961, sensitivity 91.67%, specificity 91.00%, and Youden index 0.827. Conclusion The expression level of H19 in PHC patients is significantly increased and can be used as an independent marker for the clinical diagnosis of PHC. The combined detection of H19 + AFP + γ-GT2 has good diagnostic efficacy.