异常凝血酶原和甲胎蛋白异质体比率联合检测在AFP阴性HBV相关HCC诊断中的作用

doi:10.19871/j.cnki.xfcrbzz.2022.04.006

新发传染病电子杂志 ›› 2022, Vol. 7 ›› Issue (4): 25-28.doi: 10.19871/j.cnki.xfcrbzz.2022.04.006

异常凝血酶原和甲胎蛋白异质体比率联合检测在AFP阴性HBV相关HCC诊断中的作用

陈圆圆¹, 程文兵¹, 陈川铁², 朱质斌¹, 黄德良¹, 陈燕平¹, 陈军¹

1.深圳市第三人民医院/南方科技大学附属第二医院肝病医学中心,广东深圳 518000;
2.深圳市龙岗中心医院,广东深圳 518000

收稿日期:2022-03-08 发布日期:2023-02-20
通讯作者: 陈军,Email：drchenjun@163.com
基金资助:
深圳市医学重点学科建设经费资助（SZXK076)

Role of protein induced by vitamin K absence/antagonist-Ⅱ and alpha-fetoprotein-L3 ratio combination in the diagnosis of HBV-related HCC with negative AFP

Chen Yuanyuan¹, Cheng Wenbing¹, Chen Chuantie², Zhu Zhibin¹, Huang Deliang¹, Chen Yanping¹, Chen Jun¹

1. Department of Liver Diseases, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Guangdong Shenzhen 518000, China;
2. Longgang Central Hospital, Guangdong Shenzhen 518000, China

Received:2022-03-08 Published:2023-02-20

摘要/Abstract

摘要： 目的探讨异常凝血酶原(PIVKA-Ⅱ)及甲胎蛋白异质体比率(AFP-L3%)对甲胎蛋白(AFP)阴性HBV相关肝细胞癌(HCC)的诊断价值。方法选取2018年1月至2021年10月在深圳市第三人民医院就诊AFP阴性HBV相关HCC患者（HCC组）86例,HBV相关良性肝病患者（良性肝病组）69例,健康对照者（对照组）56例,检测血清PIVKA-Ⅱ、AFP-L3%水平并进行统计分析,绘制受试者操作特征曲线（ROC曲线）分析PIVKA-Ⅱ、AFP-L3%单独及联合检测对AFP阴性HBV相关HCC的诊断效能。结果三组间血清PIVKA-Ⅱ、AFP-L3%比较,差异均有统计学意义（P<0.05）;HCC组PIVKA-Ⅱ、AFP-L3%均高于良性肝病组及对照组,差异有统计学意义（P<0.05）;PIVKA-Ⅱ诊断AFP阴性HBV相关HCC的曲线下面积（AUC）0.703,灵敏度为54.7%、特异度为91.2%,最佳截断值41.63mAU/ml;AFP-L3%的AUC面积0.681,灵敏度为60.5%、特异度为84.0%,最佳截断值5.96%;联合AFP-L3%和PIVKA-Ⅱ检测的AUC面积0.771,灵敏度为74.7%、特异度为82.4%。结论在AFP阴性HBV相关HCC诊断上,PIVKA-Ⅱ、AFP-L3%均有意义,联合检测有助于提高AFP阴性HBV相关HCC的诊断效能,为AFP阴性HBV相关HCC早期诊断提供理论依据。

关键词: 异常凝血酶原, 甲胎蛋白异质体比率, 乙型肝炎病毒, 肝细胞癌

Abstract: Objective To explore the diagnosis value of serum protein induced by vitamin K absence/antagonist-Ⅱ and alpha-fetoprotein-L3 ratio in HBV-related hepatocellular carcinoma(HCC) patients with negative AFP. Method 86 cases with HCC and 69 cases with benign liver disease and 56 cases with control group were enrolled in Shenzhen Third People's Hospital from January 2018 to October 2021. Serum PIVKA-Ⅱ and AFP-L3% were measured and statistically analyzed. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic efficacy of PIVKA-Ⅱ and AFP-L3% alone and in combination for AFP negative HBV-related HCC. Result Serum PIVKA-Ⅱ and AFP-L3% were significantly different among the three groups (P<0.05). PIVKA-Ⅱ and AFP-L3% in HCC group were higher than those in benign liver disease group and control group (P<0.05); Serum PIVKA-Ⅱ had a sensitivity of 54.7% and a specificity of 91.2% in the diagnosis of HBV-related HCC with negative AFP, while AFP-L3% had a sensitivity of 60.5% and a specificity of 84.0%. The combination between PIVKA-Ⅱ and AFP-L3% have a higher sensitivity(74.7%). Conclusion PIVKA-Ⅱ and AFP-L3% are both having diagnosis value in AFP negative HBV-related HCC. Combined detection between AFP-L3% and DCP can improve the diagnostic efficiency in AFP negative HBV-associated HCC, and provide theoretical basis for the early diagnosis of AFP negative HBV-associated HCC.

Key words: Protein induced by vitamin K absence/antagonist-Ⅱ, alpha-fetoprotein-L3 ratio, Hepatitis B virus, Hepatocellular carcinoma

陈圆圆, 程文兵, 陈川铁, 朱质斌, 黄德良, 陈燕平, 陈军. 异常凝血酶原和甲胎蛋白异质体比率联合检测在AFP阴性HBV相关HCC诊断中的作用[J]. 新发传染病电子杂志, 2022, 7(4): 25-28.

Chen Yuanyuan, Cheng Wenbing, Chen Chuantie, Zhu Zhibin, Huang Deliang, Chen Yanping, Chen Jun. Role of protein induced by vitamin K absence/antagonist-Ⅱ and alpha-fetoprotein-L3 ratio combination in the diagnosis of HBV-related HCC with negative AFP[J]. Electronic Journal of Emerging Infectious Diseases, 2022, 7(4): 25-28.

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异常凝血酶原和甲胎蛋白异质体比率联合检测在AFP阴性HBV相关HCC诊断中的作用

Role of protein induced by vitamin K absence/antagonist-Ⅱ and alpha-fetoprotein-L3 ratio combination in the diagnosis of HBV-related HCC with negative AFP

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