[1]李步任,张惠冰,张诗颜.ROC曲线及Logistic回归评价血清AFU，AFP和TK1在原发性肝癌的诊断价值[J].现代检验医学杂志,2015,30(06):56-59.[doi:10.3969/j.issn.1671-7414.2015.06.016]
　LI Bu-ren,ZHANG Hui-bing,ZHANG Shi-yan.Diagnostic Value of Serum AFU，AFP and TK1 for Primary Liver Cancer with Logistic Regression and ROC Curve[J].Journal of Modern Laboratory Medicine,2015,30(06):56-59.[doi:10.3969/j.issn.1671-7414.2015.06.016]
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ROC曲线及Logistic回归评价血清AFU，AFP和TK1在原发性肝癌的诊断价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第30卷
期数:
2015年06期
页码:
56-59
栏目:
论著
出版日期:
2015-12-30

文章信息/Info

Title:
Diagnostic Value of Serum AFU，AFP and TK1 for Primary Liver Cancer with Logistic Regression and ROC Curve
作者:
李步任; 张惠冰; 张诗颜
福建中医药大学附属福鼎医院检验科，福建福鼎355200
Author(s):
LI Bu-ren; ZHANG Hui-bing; ZHANG Shi-yan
Department of Clinical Laboratory，Affiliated Fuding Hospital of Fujian University of Traditional Chinese Medicine，Fujian Fuding 355200，China
关键词:
α-L-岩藻糖苷酶(AFU); 甲胎蛋白(AFP); 胸苷激酶1(TK1); 原发性肝癌(PLC); 联合检测
分类号:
R735.7；R730.43
DOI:
10.3969/j.issn.1671-7414.2015.06.016
文献标志码:
A
摘要:
目的探讨血清α-L-岩藻糖苷酶(α-L-fucosidase，AFU)、甲胎蛋白(alpha-fetoprotein，AFP)和胸苷激酶1(thymidine kinase1，TK1)在原发性肝癌(primary liver cancer，PLC)诊断中的临床意义。方法测定114例PLC患者、105例良性肝病患者血清AFU，AFP和TK1水平，并与同期102例健康正常对照的血清浓度水平进行比较。用Logistic回归模型绘制ROC曲线并计算曲线下面积(AUCＲOC)以评价各指标的诊断价值。结果三组间数据呈非正态分布(Kolmogorov-Sminov检验，Z=0.100～0.517，均P<0.001)。三组数据比较差异有统计学意义(Kruskal-Wallis检验，χ2=67.230～104.442，均P<0.001)。PLC组和良性肝病组患者比较，PLC组血清AFU，AFP和TK1水平高于良性肝病组，差异有统计学意义(Mann-Whitney U检验，Z=-8.772～2.077，P<0.05)。良性肝病组AFU高于正常对照组，差异有统计学意义(Mann-Whitney U检验，Z=-7.912，P<0.001)。PLC组与非肝癌组诊断性能评价ROC曲线下最佳cut-off值：AFU为40.75 U/L，AFP为10.86 μg/L和TK1为1.92 pmol/L；ROC曲线下的面积AFU为0.725，AFP为0.844，TK1为0.772，联合检测曲线下面积为0.900，其约登指数(70.5%)和敏感度(86.0%)最高。结论血清AFU，AFP和TK1联合检测对PLC的诊断具有重要价值，并且可显著增加PLC诊断的约登指数和敏感度。
Abstract:
ObjectiveTo investigate the diagnostic value for primary liver cancer (PLC) with the combined analysis of serum α-L-fucosidase (AFU)，alpha-fetoprotein (AFP) and thymidine kinase 1 (TK1)．MethodsSerum levels of AFU，AFP and TK1 were measured in：114 patients with primary liver cancer，105 patients with benign hepatic diseases and 102 normal subjects．The diagnostic value was analyzed by logistic regression equation and receiver operating characteristic curves (ROC)．ResultsStatistical distribution of the three tested tumor markers in every group was non-normally distributed (Kolmogorov-Sminov test，Z=0.100～0.517，all P<0.001)．The serum levels of AFU，AFP and TK1 in patients with PLC were significantly higher than those in patients with benign hepatic diseases (Mann-Whitney U test，Z=-8.772　to -2.077，all P<0.05)．The levels of AFU were significantly higher in patients with benign hepatic diseases than those in the normal subjects (Mann-Whitney U test，Z=-7.912，P<0.001)．Receiver operating characteristic curves (ROC) in patients with PLC versus those without PLC indicated the optimal cut-off value was 40.75 U/L for AFU，10.86 μg/L for AFP and 1.92 pmol/L for TK1．The area under ROC curve (AUC) was 0.725 for AFU，0.844 for AFP，0.772 for TK1 and 0.911 for the combination of the three tested tumor markers．The combination resulted in a higher Youden index of 70.5%　and a sensitivity of 86.0%．ConclusionThe combined detection of serum AFU，AFP　and TK1 could play a pivotal role in the diagnosis of PLC，and could drastically improve the Youden index and sensitivity for the diagnosis of PLC．

参考文献/References:

［1］Masuzaki R，Karp SJ，Omata M．New serum markers of hepatocellular carcinoma［J］．Semin Oncol，2012，39(4)：434-439．
[2]Ge T，Shen Q，Wang N，et al．Diagnostic values of alpha-fetoprotein，dickkopf-1，and osteopontin for hepatocellular carcinoma［J］．Med Oncol，2015，32(3)：59．
[3]Zhang SY，Lin BD，Li BR．Evaluation of the diagnostic value of alpha-l-fucosidase，alpha-fetoprotein and thymidine kinase 1 with ROC and logistic regression for hepatocellular carcinoma［J］．FEBS Open Bio，2015(5)：240-244．
[4]王颖，姜菲菲，王蕊，等．联合检测血清AFP，HCY和GGT对原发性肝细胞癌的诊断价值［J］．现代检验医学杂志，2014，29(1)：90-93． Wang Y，Jiang FF，Wang R，et al．Diagnostic value of combined detection to serum AFP，HCY and GGT for primary hepatocellular carcinoma［J］．Journal of Modern Laboratory Medicine，2014，29(1)：90-93．
[5]陈万青，郑荣寿，曾红梅，等．2011年中国恶性肿瘤发病和死亡分析［J］．中国肿瘤，2015，24(1)：1-10． Chen WQ，Zheng RS，Zeng HM，et al．Report of cancer incidence and mortality in China，2011［J］.China Cancer，2015，24(1)：1-10．
[6]Siegel RL，Miller KD，Jemal A．Cancer statistics，2015［J］．CA：A Cancer J Clin，2015，65(1)：5-29．
[7]Stefaniuk P，Cianciara J，Wiercinska-Drapalo A．Present and future possibilities for early diagnosis of hepatocellular carcinoma［J］．World J Gastroenterol，2010，16(4)：418-424．
[8]Song P，Feng X，Inagaki Y，et al．Clinical utility of simultaneous measurement of alpha-fetoprotein and des-gamma-carboxy prothrombin for diagnosis of patients with hepatocellular carcinoma in China：A multi-center case-controlled study of 1 153 subjects［J］．Biosci Trends，2014，8(5)：266-273．
[9]Gan Y，Liang Q，Song X．Diagnostic value of alpha-L-fucosidase for hepatocellular carcinoma：a meta-analysis［J］．Tumour Biol，2014，35(5)：3953-3960．
[10]Zhang G，Ha SA，Kim HK，et al．Combined analysis of AFP and HCCR-1 as an useful serological marker for small hepatocellular carcinoma：a prospective cohort study［J］．Dis Markers，2012，32(4)：265-271．
[11]Alegre MM，Robison RA，O'Neill KL．Thymidine Kinase 1：A Universal Marker for Cancer［J］．Cancer and Clinical Oncology，2013，2(1)：159-167． 收稿日期：2015-05-13修回日期：2015-09-22(上接55页)Leuk Res，2008，32(4)：579-585．
[5]秦亚溱，刘艳荣，李金兰，等.两例ph染色体阳性慢性粒细胞白血病患者具有少见型bcr/abl融合基因［J］．中华血液学杂志，2004，25(7)：409-412． Qin YZ，Liu YR，Li JL，et al．Two ph chromosome positive chronic myelogenous leukemia patients with rare bcr/abl fusion gene［J］．Chin J Hematol，2004，25(7)：409-412．
[6]Sugimoto T，Ijima K，Hisatomi H，et al．Second case of CML with aberrant BCR-ABL fusion transcript (e8/a2) with insertion of an inverted ABL intron 1b sequence［J］．Am J Hematol，2004，77(2)：164-166．
[7]Moreno MP，Cortinas MM，Bonomi R，et al．A novel BCR-ABL fusion transcript (e15a2) in 2 patients with atypical chronic myeloproliferative syndrome［J］．Blood，2001，97(11)：3668-3669．
[8]Iwata S，Mizutani S，Nakazawa S，et al．Heterogeneity of the breakpoint in the ABL gene in cases with BCR/ABL transcript lacking ABL exon a2［J］．Leukemia，1994，8(10)：1696-1702．
[9]Link-Lenczowska D，Sacha T，Zawada M，et al．Atypical BCR-ABL transcripts in patients with chronic myeloid leukemia--the scheme for the diagnosis and monitoring of minimal residual disease［J］．Przegl Lek，2014，71(5)：258-262．
[10]Volpe G，Cignetti A，Panuzzo C，et al．Alternative BCR/ABL splice variants in Philadelphia chromosome-positive leukemias result in novel tumor-specific fusion proteins that may represent potential targets for immunotherapy approaches［J］．Cancer Res，2007，67(11)：5300-5307．
[11]刘青．荧光定量分型PCR法与直接测序法检测HBV-DNA水平的应用价值比较［J］．中外医疗，2014(30)：34-35． Liu Q．Comparison of the application value of real-time genotyping and quantitative PCR with that of direct sequencing for HBV-DNA detection［J］．China &Foreign Medical Treatment，2014(30)：34-35．
[12]Stankov K，Mihajlovic D，Stanimirov B，et al．Quantitative real time-polymerase chain reaction method in Bcr-Abl translocation diagnostics［J］．J BUON，2010，15(2)：318-322．

备注/Memo

备注/Memo:
作者简介：李步任(1989-)，男，大学本科，检验技师，从事临床免疫学工作，Tel：0593-7832291，E-mail：382935876@qq.com。 通讯作者：张诗颜(1974-)，男，硕士，副主任技师，从事临床免疫学工作，Tel：0593-7832030，E-mail：myebox@139.com。
更新日期/Last Update: 1900-01-01