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目的探讨多血清蛋白标志谱对原发性肝癌(primary hepatic carcinoma,PHC)的诊断价值。方法测定140例PCH患者,112例肝硬化患者血清α-L-岩藻糖苷酶(AFU)、甲胎蛋白(AFP)和血清γ谷氨酰转肽酶(GGT)水平,以108例健康体检者作对照,并分析受试者工作特征(receiver operating characteristic,ROC)曲线。结果PHC组患者与肝良性病患者AFP、GGT和AFU血清浓度明显高于正常对照组血清标志物水平(P<0.05);AFP、GGT和AFU的临界值分别为:226.7μg/L、99.5u/L和38.0u/L;三者敏感度和特异度分别为:73.8%、70.2%和82.1%,90.4%、82.2%和62.1%;曲线下面积分别为0.938、0.839、0.830;诊断准确指数分别为:0.642、0.524和0.442。三指标联合诊断肝癌的敏感度与特异度分别为:95.5%和94.3%,95.0%;曲线下面积和诊断准确指数分别为:0.963和0.898。结论基于ROC曲线构建的多血清蛋白标志谱对原发性肝癌的诊断价值明显优于各单个指标。
Objective To investigate the diagnostic value of multi-serum protein markers in the diagnosis of primary hepatic carcinoma (PHC). Methods Serum levels of α-L-fucosidase (AFU), AFP and GGT in 140 patients with PCH and 112 patients with cirrhosis were measured. A total of 108 healthy people As a control, and analyzed the receiver operating characteristic (ROC) curve. Results The serum concentrations of AFP, GGT and AFU in patients with PHC and benign liver diseases were significantly higher than those in normal controls (P <0.05). The critical values of AFP, GGT and AFU were 226.7 μg / L and 99.5u / L and 38.0u / L, respectively. The sensitivity and specificity of the three indexes were 73.8%, 70.2% and 82.1%, 90.4%, 82.2% and 62.1% respectively. The area under the curve was 0.938, 0.839 and 0.830 respectively. Respectively: 0.642, 0.524 and 0.442. The sensitivities and specificities of the three indicators for the diagnosis of liver cancer were 95.5% and 94.3%, 95.0% respectively; the area under the curve and the diagnostic accuracy index were 0.963 and 0.898 respectively. Conclusion The diagnostic value of multi-serum protein markers based on ROC curve for primary hepatocellular carcinoma was significantly better than that of each single marker.