[1]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):38-42.[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(06):38-42.[doi:10.3969/j.issn.1671-7414.2018.06.010]
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CMIA法测定血清DCP与AFP对肝细胞癌的诊断价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第33卷
期数:
2018年06期
页码:
38-42
栏目:
论著
出版日期:
2018-12-24

文章信息/Info

Title:
Diagnostic Value of the Serum DCP and AFP Determined by CMIA in Hepatocellular Carcinoma
文章编号:
1671-7414(2018)06-038-05
作者:
毛丽萍1; 王跃国2; 王 健1; 黄圣勇1
1.南通市第三人民医院检验科,江苏南通 226006; 2.南通大学附属医院感染科,江苏南通 226001
Author(s):
MAO Li-ping1; WANG Yue-guo2; WANG Jian1; HUANG Sheng-yong1
Department of Clinical Laboratory,the Third People's Hospital of Nantong,Jiangsu Nantong 226006,China
关键词:
肝细胞癌;  异常凝血酶原;  甲胎蛋白
分类号:
R735.7; R730.43
DOI:
10.3969/j.issn.1671-7414.2018.06.010
文献标志码:
A
摘要:
目的 分析治疗前血清异常凝血酶原(DCP)和甲胎蛋白(AFP)在肝细胞癌(HCC)中的鉴别诊断价值。方法 采用微粒子化学发光免疫分析法(CMIA)测定2017年6月～2018年4月南通市第三人民医院住院的HBV感染相关的HCC患者110例(HCC组)、肝硬化(LC组)54例和慢性乙型肝炎(CHB组)63例治疗前血清DCP和AFP水平。两两比较采用Mann-Whitney U检验,多组比较采用Kruskal-Wallis H检验,率的比较采用χ2检验,Spearman秩相关分析DCP与AFP相关性,分析DCP和AFP诊断HCC受试者工作曲线下面积(ROC-AUC)、灵敏度及特异度。结果 HCC组DCP和AFP水平均显著高于LC组和CHB组(Z=-8.75,-4.89,-9.24和-5.37,均P<0.001)。DCP与AFP水平在LC组与CHB组间差异均无统计学意义(Z=-0.558,-0.077; P=0.577,0.939)。当对照组分别设为LC+CHB及LC组时,DCP诊断HCC的ROC-AUC均显著大于AFP(0.922 vs 0.741,Z=4.56; 0.921 vs 0.735,Z=4.15,均P<0.001)。当对照组设为LC+CHB时,DCP诊断HCC的敏感度和特异度均显著高于AFP(88.18% vs 58.18%,χ2=25.22; 92.31% vs 75.21%,χ2=12.57,均P<0.001)。DCP/AFP方案不能提高诊断HCC的敏感度(χ2=1.98,P=0.159)。DCP+AFP方案对诊断HCC的特异度有所提高(P=0.019)。当对照组设为LC组时,DCP诊断HCC的特异度显著高于AFP(94.17% vs 72.22%,χ2=4.79,P<0.05)。DCP与AFP具有弱相关性(r=0.367)。DCP与肿瘤大小呈正相关(r=0.633)。结论 DCP与AFP相比有较高的敏感度和特异度,两者联合检测能够提高HCC患者的检出率。
Abstract:
Objective To evaluate the diagnostic value of the Des-gamma-carboxyprothrombin(DCP)and alpha-fetoprotein(AFP)of serum from hepatocellular carcinoma(HCC)patients before therapy.MethodsChemiluminescent Microparticle Immunoassay(CMIA)was used to determined the serum DCP and AFP level from patients with HBV-associated HCC(n=110),liver cirrhosis(LC,n=54)and chronic hepatitis B(CHB,n=63)fromJune 2017 to April 2018 in the Third People's Hospital of Nantong.Two independent groups were analyzed by the Mann-Whitney U test.The difference amongmulti groups was analyzed by the Kruskal-Wallis H test.The rate comparison was analyzed by the chi-square test.The correlation between DCP and AFP wasanalyzed by the Spearman rank correlation analysis.Morever,the area under thereceiver operating characteristic curve(ROC-AUC),sensitivity and specificityof DCP or AFP in differentiating HCC were analyzed.Results The DCP and AFP levels in patients with HCC were significantly higher than those of patients with LC and CHB(Z=-8.75,-4.89 and -9.24,-5.37,all P<0.001).There was no significant difference in the level of DCP and AFPbetween LC and CHB groups(Z=-0.558,-0.077,P=0.577,0.939).When the control group was set as LC+CHB and LC group respectively,the ROC-AUC ofDCP in the diagnosis of HCC was significantly greater than that of AFP(0.922vs 0.741,Z=4.56; 0.921 vs 0.735,Z=4.15,all P<0.001).When the control group was set as LC+CHB,the sensitivity and specificity of DCP in the diagnosis of HCC were significantly higher than that of AFP(88.18% vs 58.18%,χ2=25.22 and 92.31% vs 75.21%,χ2=12.57,all P< 0.001).DCP/AFP cannot improve the sensitivity in the diagnosis of HCC(χ2=1.98,P=0.159).DCP+AFP could improve the specificity in the diagnosis of HCC(P=0.019).When the control group was set up as LC,the specificity of DCP indiagnosing HCC was still significantly higher than that of AFP(94.17% vs 72.22%,χ2=4.79,P<0.05).There was a weak correlation between the level ofserum DCP and AFP(r=0.367).There was a positive correlation between thelevel of serum DCP and tumor size(r=0.633).Conclusion DCP had higher sensitivity and specificity in the diagnosis of HCC than AFP.Combined detection of DCP and AFP can improve the diagnostic rate of HCC patients.

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备注/Memo

备注/Memo:
作者简介:毛丽萍(1970-),女,硕士,主任技师,主要从事分子生物学和免疫学研究,E-mail:maoliping70@163.com。
通信作者:王跃国(1967-),男,主任技师,E-mail:yueguowang@163.com。
更新日期/Last Update: 2018-11-30