摘要
目的探讨血清甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)、高尔基体蛋白73(GP73)及白细胞介素8(IL-8)联合检测在乙型肝炎相关性原发性肝癌诊断中的临床价值。方法选取确诊为乙型肝炎肝癌患者60例,乙型肝炎肝硬化患者60例,正常对照60例。肝癌患者术前均未接受任何化疗或射频消融等治疗,分别检测并比较乙型肝炎肝癌组、乙型肝炎肝硬化组及正常组之间血清AFP、AFU、GP73及IL-8浓度;分析标记物及AST、ALT及白蛋白间的相关关系;在理想临界值下,并比较四种标记物对肿瘤诊断的敏感度、特异度、准确度、阳性预测值、阴性预测值。结果乙型肝炎肝癌组、硬化组及正常组血清AFP分别为(312.41±26.56)ng/ml、(25.98±5.84)ng/ml及(20.94±4.23)ng/ml;GP73分别为(289.64±31.19)μg/L、(211.39±25.87)μg/L、(58.97±26.17)μg/L;AFU分别为(543.07±49.89)nmol/ml、(221.45±36.12)nmol/ml、(234.12±32.31)nmol/ml;IL-8分别为(146.26±14.08)pg/ml、(451.03±35.67)pg/ml、(71.23±10.34)pg/ml;差异比较均存在统计学意义(P<0.05),其中乙型肝炎肝癌组血清AFP、AFU、GP73的浓度在三组中为最高,乙型肝炎肝硬化组和正常组AFP、AFU的浓度水平相当。血清GP73肝癌组和肝硬化组大致相当,正常对照组最低;对于血清IL-8,乙型肝炎肝硬化组浓度最高,正常组浓度最低,乙型肝炎肝癌组浓度居中。对AFP、AFU、GP73、IL-8与AST、ALT、ALB间的关系进行分析,只有AFP与AFU间存在相关关系(r=-0.423,P<0.05),其他均未发现明显相关关系。联合检测四种指标的敏感度和诊断准确性均比单项检测高。结论通过适当的方法对血清AFP、AFU、GP73及IL-8进行联合检测对原发性肝癌的诊断具有重要临床价值。
Objective To investigate the clinical value of serum alpha fetoprotein（AFP）, alpha L fucosidase（AFU）, Golgi protein 73（GP73） and leukocyte mediated element 8（IL-8） detection in hepatitis B virus associated with primary hepatocellular carcinoma. Methods 60 patients with liver cancer, 60 patients with liver cirrhosis and 60 cases of normal control were selected. Before surgery, patients with liver cancer were treated by chemotherapy or radiofrequency ablation. The serum levels of AFP, GP73, AST and IL-8 were detected and compared with the normal group, and three markers, AFU, ALT and albumin were compared. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of four markers were compared. Results The serum levels of AFP in liver cancer group, atherosclerosis group and normal group were（312.41±26.56）ng/ml,（25.98±5.84）ng/ml and（20.94±4.23） ng/ml; GP73 were（289.64±31.19）μg/L,（211.39±25.87）μg/L and（58.97±26.17）μg/L; AFU were（543.07±49.89）nmol/ml,（221.45±36.12）nmol/ml and（234.12±32.31）nmol/ml; IL-8 were（146.26± 14.08）pg/ml,（451.03±35.67）pg/ml,（71.23±10.34）pg/ml and the difference was statistically significant（P〈0.05）. AFP, AFU, GP73 was the highest in liver cancer group, AFP, AFU were approximately equal in liver cirrhosis group and the normal control group, GP73 was approximately equal in liver cancer group and liver cirrhosis group, was the lowest in the normal control group. The serum IL-8 was the highest in hepatitis B cirrhosis group, was the lowest in the normal group. The relationship among AFP, AFU, GP73, IL-8, AST, ALT, ALB were analyzed, and the correlation between AFU and AFP was found to have obvious correlation（r=-0.423, P〈0.05）. The sensitivity and diagnostic accuracy of the combined detection of the four indicators were higher than those of the single detection. Conclusion Combined detection of AFP, GP73, AFU and IL-8 by appropriate method has important clinical value in the diagnosis of primary liver cancer.
出处
《中华临床医师杂志（电子版）》
CAS
2016年第9期66-70,共5页
Chinese Journal of Clinicians(Electronic Edition)
