血清甲胎蛋白、甲胎蛋白异质体、异常凝血酶原、鳞状细胞癌抗原联合检测对肝细胞癌的诊断价值(1)
[摘要]目的 探究血清甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、异常凝血酶原(DCP)、鳞状细胞癌抗原(SCCA)联合检测在肝细胞癌(HCC)的诊断价值。方法 选取2017年5月～2019年5月我院就诊的40例HCC患者、42例肝硬化(LC)患者、54例慢性乙型肝炎(CHB)患者、50例健康体检者的血清学指标及临床资料。检测各组受试者血清AFP、AFP-L3、DCP、SCCA的水平，比较4项血清标志物单独及联合诊断的工作特征曲线下面积。结果 与健康组比较，HCC组、LC组、CHB组血清AFP、AFP-L3、DCP、SCCA水平升高，差异有统计学意义(P<0.01);与LC组、CHB组比较，HCC组血清AFP、AFP-L3、DCP、SCCA水平升高，差异有统计学意义(P<0.01)。4项指标联合检测的曲线下面积均大于四者的单独检测。结论 AFP、AFP-L3、DCP、SCCA联合检测具有较高诊断效能，可为早期诊断HCC提供参考。
[关键词]肝细胞癌;甲胎蛋白类;异常凝血酶原;鳞状细胞癌抗原;诊断
[中图分类号] R735.7 [文献标识码] A [文章编号] 1674-4721(2020)8(a)-0094-04
Diagnostic value of combined detection of serum alpha-fetoprotein， alpha-fetoprotein heterogeneity-L3， des-gamma-carboxyprothrombin， squamous cell carcinoma antigen in hepatocellular carcinoma
LI Wei-wei
Department of Laboratory， Qingdao sanatorium of Shandong Province， Shandong Province， Qingdao 266071， China
[Abstract] Objective To explore the diagnostic value of combined detection of serum alpha-fetoprotein (AFP)， alpha-fetoprotein heterogeneity-L3 (AFP-L3)， des-gamma-carboxyprothrombin (DCP)， squamous cell carcinoma antigen (SCCA) in hepatocellular carcinoma (HCC). Methods From May 2017 to May 2019， 40 patients with HCC， 42 patients with liver cirrhosis (LC)， 54 patients with chronic hepatitis B (CHB)， and 50 healthy people were selected from our hospital for serological indicators and clinical data. The levels of serum AFP， AFP-L3， DCP and SCCA were measured in each group， and the area under the curve of receiver operating characteristic (ROC) of 4 serum markers， alone or in combination， were compared. Results The levels of AFP， AFP-L3， DCP and SCCA in HCC group， LC group and CHB group were higher than those in the healthy group， the differences were statistically significant (P<0.01). The levels of AFP， AFP-L3， DCP and SCCA in HCC group were higher than those in LC group and CHB group， the differences were statistically significant (P<0.01). The area under ROC curve of the combined detection were all higher than those of four individual detections. Conclusion The combined detection of AFP， AFP-L3， DCP， and SCCA has a high detection efficiency， and provide a reliable reference for the early diagnosis of HCC.
[Key words] Hepatocellular carcinoma; Alpha-fetoproteins; Des-gamma-carboxyprothrombin; Squamous cell carcinoma antigen; Diagnosis
肝细胞癌(hepatocellular carcinoma，HCC)是全球第六位常見恶性肿瘤，位列第三的肿瘤致死病因，按病理类型占肝癌的85%～90%[1-2]。由于肝癌进展快、预后差的特点，多数肝癌患者确诊时已处于肿瘤中晚期，因此对肝癌患者的早期发现和早期诊断尤为重要。血清甲胎蛋白(alpha-fetoprotein，AFP)是肝癌诊断中最常用的指标，但单独使用血清AFP诊断肝癌的特异性和灵敏性尚有欠缺，仍有部分肝癌患者血清AFP检测呈阴性，一定程度上增加了早期诊断HCC的难度。近年来，其他血清标志物也逐步应用于HCC的早期诊断，本研究联合检测血清AFP、甲胎蛋白异质体(alpha-fetoprotein heterogeneity-L3，AFP-L3)、异常凝血酶原(des-gamma-carboxyprothrombin，DCP)、鳞状细胞癌抗原(squamous cell carcinoma antigen，SCCA)在HCC患者血清中的表达水平，以确定这4项血清标志物联合检测对HCC的诊断价值，现报道如下。, 百拇医药(李薇薇)
[关键词]肝细胞癌;甲胎蛋白类;异常凝血酶原;鳞状细胞癌抗原;诊断
[中图分类号] R735.7 [文献标识码] A [文章编号] 1674-4721(2020)8(a)-0094-04
Diagnostic value of combined detection of serum alpha-fetoprotein， alpha-fetoprotein heterogeneity-L3， des-gamma-carboxyprothrombin， squamous cell carcinoma antigen in hepatocellular carcinoma
LI Wei-wei
Department of Laboratory， Qingdao sanatorium of Shandong Province， Shandong Province， Qingdao 266071， China
[Abstract] Objective To explore the diagnostic value of combined detection of serum alpha-fetoprotein (AFP)， alpha-fetoprotein heterogeneity-L3 (AFP-L3)， des-gamma-carboxyprothrombin (DCP)， squamous cell carcinoma antigen (SCCA) in hepatocellular carcinoma (HCC). Methods From May 2017 to May 2019， 40 patients with HCC， 42 patients with liver cirrhosis (LC)， 54 patients with chronic hepatitis B (CHB)， and 50 healthy people were selected from our hospital for serological indicators and clinical data. The levels of serum AFP， AFP-L3， DCP and SCCA were measured in each group， and the area under the curve of receiver operating characteristic (ROC) of 4 serum markers， alone or in combination， were compared. Results The levels of AFP， AFP-L3， DCP and SCCA in HCC group， LC group and CHB group were higher than those in the healthy group， the differences were statistically significant (P<0.01). The levels of AFP， AFP-L3， DCP and SCCA in HCC group were higher than those in LC group and CHB group， the differences were statistically significant (P<0.01). The area under ROC curve of the combined detection were all higher than those of four individual detections. Conclusion The combined detection of AFP， AFP-L3， DCP， and SCCA has a high detection efficiency， and provide a reliable reference for the early diagnosis of HCC.
[Key words] Hepatocellular carcinoma; Alpha-fetoproteins; Des-gamma-carboxyprothrombin; Squamous cell carcinoma antigen; Diagnosis
肝细胞癌(hepatocellular carcinoma，HCC)是全球第六位常見恶性肿瘤，位列第三的肿瘤致死病因，按病理类型占肝癌的85%～90%[1-2]。由于肝癌进展快、预后差的特点，多数肝癌患者确诊时已处于肿瘤中晚期，因此对肝癌患者的早期发现和早期诊断尤为重要。血清甲胎蛋白(alpha-fetoprotein，AFP)是肝癌诊断中最常用的指标，但单独使用血清AFP诊断肝癌的特异性和灵敏性尚有欠缺，仍有部分肝癌患者血清AFP检测呈阴性，一定程度上增加了早期诊断HCC的难度。近年来，其他血清标志物也逐步应用于HCC的早期诊断，本研究联合检测血清AFP、甲胎蛋白异质体(alpha-fetoprotein heterogeneity-L3，AFP-L3)、异常凝血酶原(des-gamma-carboxyprothrombin，DCP)、鳞状细胞癌抗原(squamous cell carcinoma antigen，SCCA)在HCC患者血清中的表达水平，以确定这4项血清标志物联合检测对HCC的诊断价值，现报道如下。, 百拇医药(李薇薇)