血清AFP-IgM复合物对原发性肝癌的诊断意义
혈청AFP-IgM복합물대원발성간암적진단의의
Detection of the diagnosis about primary hepatocellular carcinoma with the AFP-IgM immune complexes in serum
  • 万方数据
    中华检验医学杂志 중화검험의학잡지
    CHINESE JOURNAL OF LABORATORY MEDICINE
    2008年 7期 789-792 ,共4页

    蒋敬庭%WU Chang-ping%吴骏%秦锡虎%孙达成%季枚%XU Bin%邓海峰%陆明洋%ZHOU Guo-ping%李敏%郑晓%刘检%石亮荣%Ning Xu%Peter Nilsson-Ehle

    장경정%WU Chang-ping%오준%진석호%손체성%계매%XU Bin%산해봉%륙명양%ZHOU Guo-ping%리민%정효%류검%석량영%Ning Xu%Peter Nilsson-Ehle

    癌,肝细胞%肝肿瘤%甲胎蛋白类%免疫球蛋白M%肿瘤标记,生物学 癌,肝細胞%肝腫瘤%甲胎蛋白類%免疫毬蛋白M%腫瘤標記,生物學
    암,간세포%간종류%갑태단백류%면역구단백M%종류표기,생물학
    Carcinoma,hepatocellular%Liver neoplasms%alpha-Fetoproteins%Immunoglobulin M%Tumor markers,biological
    目的 评价新型肿瘤标志物甲胎蛋白-IgM免疫复合物(AFP-IgM)对原发性肝细胞癌(PHC)的诊断意义.方法 用酶联免疫吸附法与电化学发光法分别检测103名健康人、74例原发性肝细胞癌、27例中度肝硬化和63例慢性肝炎患者血清AFP-IgM与甲胎蛋白(AFP)含量.以非肝癌组(健康人、中度肝硬化和慢性肝炎)作为对照组.结果 AFP的ROC曲线下面积大于AFP-IgM(0.85 vs 0.72,Z=3.21),并应用ROC曲线确定AFP-IgM和AFP的临界值分别为3×105AU/L和10ug/L.在此临界值下,AFP-IgM和AFP对PHC的敏感度分别为64.9%和79.7%,特异度分别为75.6%和80.3%,两者的有效性相近;但对早期(Ⅰ与Ⅱ期)肝癌诊断时,AFP-IgM的ROC曲线下面积大于AFP(0.91 vs 0.82,Z=1.73),差异具有统计学意义,其敏感度分别为94.4%和72.2%,特异度分别为81.9%和79.9%;联合检测以两项均为阳性诊断原发性肝癌:特异度可达89.1%,有效性为79.0%.结论 采用AFP联合AFP-IgM检测可提高PHC诊断的特异度和有效性,但对于原发性肝癌的早期诊断AFP-IgM的敏感度与特异度均比AFP更高,AFP-IgM对原发性肝癌的早期诊断更具重要意义.
    목적 평개신형종류표지물갑태단백-IgM면역복합물(AFP-IgM)대원발성간세포암(PHC)적진단의의.방법 용매련면역흡부법여전화학발광법분별검측103명건강인、74례원발성간세포암、27례중도간경화화63례만성간염환자혈청AFP-IgM여갑태단백(AFP)함량.이비간암조(건강인、중도간경화화만성간염)작위대조조.결과 AFP적ROC곡선하면적대우AFP-IgM(0.85 vs 0.72,Z=3.21),병응용ROC곡선학정AFP-IgM화AFP적림계치분별위3×105AU/L화10ug/L.재차림계치하,AFP-IgM화AFP대PHC적민감도분별위64.9%화79.7%,특이도분별위75.6%화80.3%,량자적유효성상근;단대조기(Ⅰ여Ⅱ기)간암진단시,AFP-IgM적ROC곡선하면적대우AFP(0.91 vs 0.82,Z=1.73),차이구유통계학의의,기민감도분별위94.4%화72.2%,특이도분별위81.9%화79.9%;연합검측이량항균위양성진단원발성간암:특이도가체89.1%,유효성위79.0%.결론 채용AFP연합AFP-IgM검측가제고PHC진단적특이도화유효성,단대우원발성간암적조기진단AFP-IgM적민감도여특이도균비AFP경고,AFP-IgM대원발성간암적조기진단경구중요의의.
    Objective To evaluate the significance of AFP-IgM, this is one of new tumor markers, in the diagnosis of primary hepatocellular carcinoma (PHC). Methods The contents of AFP-IgM and AFP in serum of 103 healthy subjects, 74 patients suffered primary hepatic carcinoma, 27 patients affected by liver cirrhosis and 63 patients affected by chronic hepatitis were detected by means of enzyme linked immunosorbent assay and electrochemiluminescence. No-PHC is comprised of liver cirrhosis,chronic hepatitis and health subjects as control group. Results The area under ROC curve of AFP was larger than that of AFP-IgM (0.85 vs 0.72, Z=3.21) and the best cut-off value of AFP-IgM and AFP was 3×105-AU/L and 10 ug/L respectively, which was determined by ROC curve. Under the cut-off value, the sensitivity of AFP- lgM and AFP for PHC were 64.9% and 79.7%, and the specificity were 75.6% and 80.3%, yet their efficacies were similar. However, for early diagnosis of liver cancer (stage Ⅰ and Ⅱ), the area under ROC curve of AFP-IgM was larger than that of AFP (0.91 vs 0.82,Z=1.73). The sensitivity of AFP-IgM andAFP were 94.4% and 72. 2%, and the specificity were 81.9% and 79.9%. The differences of AFP-IgMand AFP for early diagnosis of liver cancer were statistically significant. When both of the test results combined AFP-IgM with AFP are positive, it can be diagnosed as liver cancer. The specificity of combineddetermination of the two forms was 89.1%, and the efficacy was 79. 0%. Conclusions Both of thesensitivity and specificity of the AFP-IgM test were higher than that of the AFP for early diagnosis of livercancer. We also found that combined determination of the two forms significantly increased the specificityand the positive predictive value for the diagnosis of PHC, thus AFP-IgM was of especially significance forearly diagnosis of liver cancer.
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