Clinical value of protein induced by vitamin K absence or antagonist-Ⅱ in diagnosis of hepatocellular carcinoma
- Author:
- No author available
- Journal Title:
- World Chinese Journal of Digestology
- Issue:
- 7
- DOI:
- 10.11569/wcjd.v26.i7.425
- Key Word:
- 异常凝血酶原复合物;原发性肝癌;甲胎蛋白;临床价值
Abstract： 目的 探讨血清肿瘤标志物异常凝血酶原复合物(protein induced by vitamin K antagonist-Ⅱ,PIVKA-Ⅱ)和甲胎蛋白(alpha fetoprotein,AFP)在原发性肝癌(hepatocellular carcinoma,HCC)诊断效能的差异.方法 采用电化学发光法对2016-04/2017-04天津市第二人民医院住院的初治的285例HCC患者、60例肝硬化患者、60例慢性病毒性肝炎患者(慢性乙型肝炎38例,慢性丙型肝炎22例)、30例其他慢性肝病患者(药物性肝炎14例,酒精性肝炎8例,非酒精性脂肪性肝炎8例)、25例胃、结直肠癌患者、40例健康对照人群进行血清PIVKA-Ⅱ和AFP测定.采用ROC曲线比较PIVKA-Ⅱ、AFP单独诊断HCC的效能以及敏感性和特异性;并探讨PIVKA-Ⅱ与肿瘤直径、BCLC分期等的相关性.结果 血清PIVKA-Ⅱ和AFP在HCC组表达水平均高于其他病例组(均P＜0.01).PIVKA-Ⅱ诊断HCC的敏感性高于AFP(84.2％ vs 70.9％,P＜0.001);PIVKA-Ⅱ诊断HCC的特异性高于AFP(81.4％ vs 65.6％,P＜0.001).PIVKA-Ⅱ和AFP联合诊断的敏感性高于PIVKA-Ⅱ单项检测(89.5％ vs 84.2％),但差异无统计学意义(P＞0.05).PIVKA-Ⅱ、AFP诊断HCC的ROC-AUC分别为0.865、0.768,PIVKA-Ⅱ诊断HCC的ROC-AUC大于AFP(0.865 vs 0.768,P＜0.001).HCC患者血清PIVKA-Ⅱ水平与性别、肿瘤数目、有无微血管侵袭相关,与年龄、病毒感染、肿瘤直径、门静脉癌栓、Child-Pugh分级无关.HCC患者血清PIVKA-Ⅱ水平随着BCLC分期的升高而升高(H=48.70,P＜0.001).结论 血清PIVKA-Ⅱ对HCC的综合诊断效能略优于AFP,HCC患者血清PIVKA-Ⅱ水平与性别、肿瘤数目、伴有微血管侵袭相关.
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