[1]张巧娣,谢而付,凌 芸,等.壳多糖酶3样蛋白1与甲胎蛋白在肝细胞癌诊断中的比较[J].现代检验医学杂志,2017,32(01):45-47,52.[doi:10.3969/j.issn.1671-7414.2017.01.013]
　ZHANG Qiao-di,XIE Er-fu,LING Yun,et al.Comparative Diagnostic Value of Chitinase 3-Like 1 Protein and AFP in the Diagnosis of Hepatocellular Carcinoma[J].Journal of Modern Laboratory Medicine,2017,32(01):45-47,52.[doi:10.3969/j.issn.1671-7414.2017.01.013]
点击复制

壳多糖酶3样蛋白1与甲胎蛋白在肝细胞癌诊断中的比较()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年01期
页码:
45-47,52
栏目:
论著
出版日期:
2017-01-25

文章信息/Info

Title:
Comparative Diagnostic Value of Chitinase 3-Like 1 Protein and AFP in the Diagnosis of Hepatocellular Carcinoma
文章编号:
1671-7414(2017)01-045-04
作者:
张巧娣; 谢而付; 凌 芸; 刘雁雁; 杨瑞霞; 徐华国
南京医科大学第一附属医院检验学部,南京 210029
Author(s):
ZHANG Qiao-di; XIE Er-fu; LING Yun; LIU Yan-yan; YANG Rui-xia; XU Hua-guo
Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
关键词:
壳多糖酶3样蛋白1;  甲胎蛋白;  肝细胞癌;  慢性乙型肝炎;  诊断价值
分类号:
R735.7; R730.43
DOI:
10.3969/j.issn.1671-7414.2017.01.013
文献标志码:
A
摘要:
目的 比较壳多糖酶3样蛋白1(chitinase 3-like 1,CHI3L1)和甲胎蛋白(alpha-fetoprotein,AFP)对肝细胞癌(HCC)的诊断的差异。方法 选取南京医科大学第一附属医院2015年12月份～2016年4月份收治入院且经病理学证实HCC患者100例,同时按性别和年龄配对选择慢性乙型肝炎患者100例和健康体检者59例作为对照组,分别检测HCC组、慢性乙型肝炎组和健康体检者的血清CHI3L1和AFP,使用STATA 12.0统计学软件,各组和两组之间血清CHI3L1和AFP是否存在差异分别使用Kruskal-Wallis H检验和Mann-Whitney U检验,同时使用MedCal Ver 15.2.2软件的诊断效能分析比较CHI3L1和AFP对HCC的诊断价值。结果 多组之间血清CHI3L1水平存在显著差异(χ2=93.19,P=0.000),进一步进行两两比较,结果显示HCC组血清CHI3L1均显著高于慢性乙型肝炎组和健康体检组(P值均为0.000,z值分别为8.766和7.400); 多组之间血清AFP水平存在显著差异(χ2=147.54,P=0.000),HCC组血清AFP均显著高于慢性乙型肝炎组和健康体检组(z=10.938,9.033; P值均为0.000); 将HCC与慢性乙型肝炎组的CHI3L1和AFP做ROC曲线,CHI3L1的AUC为0.859(95%可信区间:0.803～0.904),临界值为76.8 pg/ml,敏感度和特异度分别为85%和79%; AFP的AUC为0.948(95%可信区间:0.904～0.974),临界值为7.6 ng/ml,敏感度和特异度分别为85%和98%,AFP的诊断效能优于CHI3L1(P=0.006); HCC与健康对照组之间ROC曲线结果比较,CHI3L1的AUC为0.852(95%可信区间:0.787～0.903),临界值为76.8 pg/ml,敏感度和特异度分别为85%和76%; AFP的AUC为0.929(95%可信区间:0.878～0.964),临界值为7.8 ng/ml,敏感度和特异度分别为84%和100%; AFP的诊断效能也优于CHI3L1,差异有统计学意义(P=0.045)。结论 CHI3L1和AFP对HCC均具有很高的诊断效能,但AFP的诊断效能优于CHI3L1。
Abstract:
Objective To investigate the different diagnostic value of serum Chitinase 3-like 1 protein(CHI3L1)and Alpha-fetoprotein(AFP)in diagnosing hepatocellular carcinoma(HCC).Methods One hundreds HCC patients confirmed by histopathology were recruited between December,2015 to April,2016 from the First Affiliated Hospital of Nanjing Medical University.Simultaneously,100 patients with chronic hepatitis B and 59 healthy individuals,matched by sex and age with HCC patients,were recruited as control groups.Serum CHI3L1and AFP were measured in different groups and the difference were analyzed by STATA 12.0 Statistical software.The ability of these two items in differentiatingdifferent group was analyzing by ROC curve using MedCal Ver 15.2.2 software.Results Serum CHI3L1 were significantly differences in the three groups using Kruskal-Wallis analysis(χ2=93.19,P=0.000),thedifferences were further compared in different two groups using Mann-Whitney analysis.The results showed that serum CHI3L1 in HCC group were significantly higher than in chronic hepatitis B and healthy control group(P=0.000,z=8.766,7.400).Serum AFP were significantly differences in the three groups using Kruskal-Wallis analysis(χ2=147.54,P=0.000),and the differences were further compared in different two groups using Mann-Whitney analysis.The results showed that serum AFP in HCC group were significantly higher than in chronic hepatitis B and healthy control group(P=0.000,z=10.938,9.033).The ROC curve analysis of serum CHI3L1 and AFP for differentiating HCC group from CHB groupshowed that CHI3L1 yield AUC of 0.859(95% CI:0.803～0.904)with 85% sensitivity,79% specificity and 76.8 pg/ml cut-off value,AFP yield AUC of 0.948(95%CI:0.904～0.974)with 85% sensitivity,98% specificity and 7.6 ng/ml cut-off value,in distinguishing HCC with CHB group,the power of AFP was superior tothat of CHI3L1(P=0.006).The ROC curve analysis of serum CHI3L1 and AFP for differentiating HCC group from healthy individuals group showed that CHI3L1 yield AUC of 0.852(95% CI:0.787～0.903)with 85% sensitivity,76% specificityand 76.8 pg/ml cut-off value,AFP yield AUC of 0.929(95% CI:0.878～0.964)with 84% sensitivity,100% specificity and 7.8 ng/ml cut-off value,in distinguishing HCC with healthy individuals group,the power of AFP was also superiorto that of CHI3L1(P=0.045).Conclusion Serum CHI3L1similar to AFP has much power ability to diagnosis HCC,but AFP was superior toCHI3L1.

参考文献/References:

[1] Hakala BE,White C,Recklies AD.Human cartilage gp-39,a majorsecretory product of articular chondrocytes and synovial cells,is a mammalian member of a chitinase protein family[J].J Biol Chem,1993,268(34):25803-25810.
[2] Johansen JS, Jensen BV, Roslind A,et al.Serum YKL-40,a new prognostic biomarker in cancer patients?[J].Cancer Epidemiol Biomarkers Prev,2006,15(2):194-202.
[3] Ryder SD.Guidelines for the diagnosis and treatment of hepatocellular carcinoma(HCC)in adults[J].Gut,2003,52(Suppl 3):iii1-8.
[4] Evdokimova VN,Butterfield LH.Alpha-fetoprotein and other tumour-associated antigens for immunotherapy of hepatocellular cancer[J].Expert Opin BiolTher,2008,8(3):325-336.
[5] Sherman M.Alphafetoprotein:an obituary[J].J Hepatol,2001,34(4):603-605.
[6] Rich N,Singal AG.Hepatocellular carcinoma tumour markers:current roleand expectations[J].Best Pract Res Clin Gastroenterol,2014,28(5):843-853.
[7] Xiao XQ,Hassanein T,Li QF,et al.YKL-40 expression in human hepatocellular carcinoma:a potential biomarker[J].Hepatobiliary Pancreat Dis Int,2011,10(6):605-610.
[8] 王宗泽.乙型肝炎病毒X蛋白对患者发展为肝癌的影响[J].现代检验医学杂志,2008,23(3):91-93. Wang ZZ.The development of hepatic cancer influence by the hepatitis B virus X protein[J].Journal of Modern Laboratory Medicine,2008,23(3):91-93.
[9] 左 铎,罗 艺,郭 华,等.联合检测血清miR-125b和AFP对原发性肝细胞癌的诊断价值[J].中国肿瘤临床,2014,41(10):662-666. Zuo D,Luo Y,Guo H,et al.The diagnosis value of combined detection of serum miR-125b and alpha-fetoprotein for primary hepatocellular carcinoma[J].Chin J Clin Oncol,2014,41(10):662-666.
[10] Ahmed S,de Souza NN,Qiao W,et al.Quality of life in hepatocellular carcinoma patients treated with transarterial chemoembolization[J].HPBSurg,2016,(2016):6120143.
[11] 徐 斌,蒋敬庭,吴昌平.AFP-IgM复合物联合AFP对诊断肝癌的互补作用[J].现代检验医学杂志,2010,25(1):71-73. Xu B,Jiang JT,Wu CP.Complementary effect between AFP and AFP-IgM in the process of hepatocellular carcinoma diagnosis[J].Journal of Modern Laboratory Medicine,2010,25(1):71-73.

相似文献/References:

[1]申 旺,杨文丽,叶丽燕,等.血清唾液酸在原发性肝癌和转移性肝癌诊断中的临床价值[J].现代检验医学杂志,2015,30(01):140.[doi:10.3969/j.issn.1671-7414.2015.01.042]
　SHEN Wang,YANG Wen-li,YE Li-yan,et al.Clinical Value of Serum Sialic Acid Detection for Diagnosis in Primary Hepatic Carcinoma and Metastatic Hepatic Carcinoma[J].Journal of Modern Laboratory Medicine,2015,30(01):140.[doi:10.3969/j.issn.1671-7414.2015.01.042]
[2]毛丽萍,何义民,韩 刚,等.血浆Dickkopf同源物1检测对肝细胞癌的诊断价值[J].现代检验医学杂志,2016,31(05):62.[doi:10.3969/j.issn.1671-7414.2016.05.016]
　MAO Li-ping,HE Yi-min,HAN Gang,et al.Diagnosis Value of Detecting Plasma Dickkopf-1 Patients with Hepatocellular Carcinoma[J].Journal of Modern Laboratory Medicine,2016,31(01):62.[doi:10.3969/j.issn.1671-7414.2016.05.016]
[3]刘冲,唐浩,邓霖,等.血清miRNA-186,miRNA-30c在肝细胞性癌中诊断价值的研究[J].现代检验医学杂志,2016,31(06):44.[doi:10.3969/j.issn.1671-7414.2016.06.012]
　LIU Chong,TANG Hao,DENG Lin,et al.Research of Diagnostic Application of Serum miRNA-186 and miRNA-30c in Patients with Hepatocellular Carcinoma[J].Journal of Modern Laboratory Medicine,2016,31(01):44.[doi:10.3969/j.issn.1671-7414.2016.06.012]
[4]周淑燕,卓传尚,柳丽娟,等.PIVKA-II和AFP联合检测对原发性肝癌的诊断价值[J].现代检验医学杂志,2017,32(01):69.[doi:10.3969/j.issn.1671-7414.2017.01.019]
　ZHOU Shu-yan,ZHUO Chuan-shang,LIU Li-juan,et al.Clinical Value of Serum PIVKA-lI and AFP Detection for Primary Hepatocellular Carcinoma[J].Journal of Modern Laboratory Medicine,2017,32(01):69.[doi:10.3969/j.issn.1671-7414.2017.01.019]
[5]石玉如,岳 莉,赵长城,等.血清壳多糖酶3样蛋白1检测在不同肝脏疾病中的应用价值[J].现代检验医学杂志,2017,32(06):39.[doi:10.3969/j.issn.1671-7414.2017.06.001]
　SHI Yu-ru,YUE Li,ZHAO Chang-cheng,et al.Clinical Application Value of Chitinase-3-like Protein 1 in Patients with Different Liver Diseases[J].Journal of Modern Laboratory Medicine,2017,32(01):39.[doi:10.3969/j.issn.1671-7414.2017.06.001]
[6]颜 丽,魏莲花,齐发梅,等.血清TSGF,AFP,CEA和FER联合检测在肝脏恶性肿瘤诊断中的应用价值[J].现代检验医学杂志,2018,33(05):24.[doi:10.3969/j.issn.1671-7414.2018.05.007]
　YAN Li,WEI Lian-hua,QI Fa-mei,et al.Significance of Combined Detection of TSGF,AFP,CEA and FER in the Diagnosis of Hepatic Malignancy[J].Journal of Modern Laboratory Medicine,2018,33(01):24.[doi:10.3969/j.issn.1671-7414.2018.05.007]
[7]梁培松,王结珍,王伟佳,等.广东省中山地区孕中期产前筛查血清标志物中位数方程的建立[J].现代检验医学杂志,2018,33(05):46.[doi:10.3969/j.issn.1671-7414.2018.05.013]
　LIANG Pei-song,WANG Jie-zhen,WANG Wei-jia,et al.Establishment of the Median Equation of Prenatal Screening Serum Marker of the Second Trimester in Zhongshan of Guangdong Province[J].Journal of Modern Laboratory Medicine,2018,33(01):46.[doi:10.3969/j.issn.1671-7414.2018.05.013]
[8]毛丽萍,王跃国,王 健,等.CMIA法测定血清DCP与AFP对肝细胞癌的诊断价值[J].现代检验医学杂志,2018,33(06):38.[doi:10.3969/j.issn.1671-7414.2018.06.010]
　MAO Li-ping,WANG Yue-guo,WANG Jian,et al.Diagnostic Value of the Serum DCP and AFP Determined by CMIA in Hepatocellular Carcinoma[J].Journal of Modern Laboratory Medicine,2018,33(01):38.[doi:10.3969/j.issn.1671-7414.2018.06.010]

备注/Memo

备注/Memo:
基金项目:江苏省实验诊断学重点实验室基金(XK201114); 江苏高校优势学科建设工程资助项目。
作者简介:张巧娣(1970-),女,本科,副主任技师,主要从事免疫学研究与临床工作,E-mail:kiddy1010@sohu.com。
通讯作者:谢而付,E-mail:xieerfu791010@163.com。
更新日期/Last Update: 2017-01-20